Child Abuse

Question 1

Physical abuse

Answer 1

intentional bodily harm. slapping, pinching, choking, kicking, physical restraints

Question 2

Sexual abuse

Answer 2

oral, anal, vaginal, pornography, prostitution.

Question 3

emotional abuse

Answer 3

not reported.

Question 4

neglect abuse

Answer 4

failing to act as parent or caregiver. results in injury or harm

Question 5

what is ACES

Answer 5

adverse childhood events. traumatic events that can have lasting effects on kids

Question 6

Causes of ACE

Answer 6

any abuse, substance abuse from parents, divorce, suicide of family member, witness of violence, imprisoned family member, abandonment, childs basic needs unmet.

Question 7

Behaviors developed from ACE

Answer 7

disrupted neurodevelopment, difficulty controlling anger, hallucinations, depression, panic reactions, anxiety, somatic problems, flashbacks, drug use, obesity, physical inactivity, suicide, etoh, sti, repetition of trauma, perpetrate domestic violence

Question 8

Long term consequences of ACE

Answer 8

ischemic heart disease, cancer, chronic lung disease, chronic emphysema, asthma, liver disease, skeletal fractures, HIV, homeless, prostitution, delinquency, unemployment, re victimization, abuse of own children.

Question 9

Risk factors for parent to abuse

Answer 9

poverty, hx of abuse, isolation, younger parent, unrealistic expectations, impulse control issues, substance abuse, DV, hx with CPS, low income, lack of support, mental health problems, poor self esteem

Question 10

risk factors for children to be abused

Answer 10

younger kids like toddlers, developmental delays, hx of premature birth, congenital health issues, behavior issues, corporal punishment, picky eating, crying, toilet training opposition

Question 11

common areas of bruising

Answer 11

shin, knee, forehead, upper leg - if walking

Question 12

uncommon areas for bruises

Answer 12

trunk, hands, buttocks, ears, neck, face - if walking. any bruises if its an infant

Question 13

raccoon eyes

Answer 13

from shaken baby syndrome, bruising around eyes, retinal hemorrhage, need full workup

Question 14

mongolian spots (dermal melanocytosis)

Answer 14

not abuse, born with them, bruise like birthmark often on back, disappears over time

Question 15

Coining

Answer 15

medical practice for some cultures, back is rubbed until echymossis occurs, only time to report is if child has bleeding disorders or cancer. not painful

Question 16

Cupping

Answer 16

cups suctioned on back, not reported.

Question 17

bite marks

Answer 17

animals usually tear flesh, humans is compressive injury, always report. clean wound and monitor for infection, give abx, pain mx.

Question 18

Burns

Answer 18

scalds from splash or immersion, contact like branding, microwave, flame. wound care, use lukewarm water, maintain fluid volume, temperature, nutrition, pain relief, O2.

Question 19

medical child abuse

Answer 19

munchausen syndrome by proxy, child has often medical visits, manipulate s/s or labs, most important is safety of child

Question 20

what can mimic child abuse

Answer 20

ITP, osteogenesis imperfecta, hemophilia A, von Willebrand disease, Cancer

Question 21

facts about sexual abuse

Answer 21

abuser is usually male, close to victim, smart. victim often doesnt want to tell. nurse should ask about sore throat, incontinence, genital burning.

Question 22

role as nurse with abuse victims

Answer 22

1. mandated reporters
2. assessment - stories should line up, head to toe, assess throat, skin, ask about private areas, ask about emotional state
3. tx - tx injury, support mental health, Report, referrals, remove child from home