Flashcards in Child abuse and neglect Deck (17)
T/F, in the US each state defines child abuse and neglect within its own civil & criminal codes.
Types of child abuse?
Who are the MC perpetrators?
Certain children are more likely to be victims of child abuse, who are these children?
-age less than 3YO
-Past hx of abuse; 50% chance of experiencing further abuse and 10% chance of dying.
-children w/ speech/language disorders, learning disabilities, non-conduct psych problems
-children with handicaps, chronic illness
-hyperactive adopted and step children.
What is the more prevalent form of child abuse? What are the types?
-physical = food, clean clothes, basic hygiene
-simplify care as much as possible
-give written instructions
-remove barriers to access
*may require hospitalization:
-for serious medical conditions
-to protect the child
-to observe the parent-child interaction.
What is the most commonly injured area of the body? What is the most common type of injury seen?
-fx of maxilla, mandible, or facial bones
-oropharyngeal gonorrhea or syphillis
-black eyes or basilar skull fx
-bruising or scarring corners of the mouth from being gagged
Bruises are MC type of injury.
- central bruising suggests abuse
-bruising in babies who are not mobile is uncommon
-ligature marks or rope burns of the neck, wrists, and ankles
DDX of bruises
-bruises uniform in color
-inflicted bruises have different colors
-check clotting studies, CBC w/ platelets, PT, PTT
Henoch Schonlein purpura
Clinical manifestations of abuse
-burns: immersion, microwave, stun gun burns, cigarette
-fractures; fx of multiple stages of healing
PE looking for what signs?
If you suspect abuse what labs/studies should you get?
-skin lesions, swelling, deformity
-bone tenderness, reluctance to use and extremity
-retinal hemorrhages (shaken baby syndrome)
-trauma to genital or mouth
-bleeding eval: CBC w/ platelets, PT, PTT
-CMP: check LFT, electrolytes, r/o bone dz
-toxicology: inappropriate administration of medications
-skeletal survey (any child less than 2YO w/ concerning fx, abd injury or concern for head trauma)
sexual assault in children definition
-when child engages in sexual activity for which he/she cannot give consent, is unprepared for developmentally, cannot comprehend, and/or an activity that violates the law or social taboos of society
Sexual abuse includes:
-forms of oral-genital, genital or anal contact with a child
--involving the child in pornography
Is sexual play normal?
yes. Involves children separated by no more than 4 years.
Women between the ages of ___ and __ are at greatest risk of intimate partner violence.
Women between 20-34 are at greatest risk of intimate partner violence.
Children who witness intimate partner show an increase in?
-aggression and conduct disorders
-anxiety and intrusive thoughts
-disrupted sleep patterns and depression
What is RADAR?
Routinely screen pts for abuse.
Ask direct questions
Assess safety of victim and children
Review options/referrals/reportng requirements.
*Perform this on new pts, yearly, when mother or teenager is involved in a new intimate relationship or becomes pregnant.
Barriers to reporting sexual abuse?
-PCP though alternative strategies could be more effective then child protective services.
-inadequate training to recognize abuse
-perception the CPS intervention is ineffective.