Answer 3 for NRS 434 Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse

Answer 3 for NRS 434 Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse

Infants are particularly at a higher risk of child abuse and maltreatment due to their defencelessness and dependence on others as well as the intricate processes involved in their psychosocial, neurological, and cognitive development (GWIG, 2016). The most common types of abuse among infants include abusive head trauma from aggressive shaking (shaken baby syndrome), physical spanking (with bruises), burning, and falls from throwing or pushing (American Academy of Pediatrics, n.d.). Some of the infant abuses lead to fatalities, and in 78% of the cases, at least one parent is involved in the infant’s abuse (U.S. Department of Health & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, & Children’s Bureau, 2018).

Warning signs and emotional and physical assessment findings that may indicate child abuse in infants include: ominous watchfulness by the infant, looking away from parent/caregiver, passiveness, withdrawal, being overly compliant, developmental delays, and unaddressed bruises or injury marks in various stages of healing (Ho et al., 2017). In addition, signs of infant abuse may also be exhibited by the parent or adult caregiver, including denial or delay in seeking healthcare for infant injuries, blaming the infant for injuries or being burdensome, and little show of concern for the infant through touches or looks (GWIG, 2016). Some cultural practices that may be misidentified for abuse include the folk healing practice of cupping among some Chinese, Tibetian, and Middle Eastern cultural groups in which dry or wet cups are used for cupping therapy to suction the subcutaneous tissues underneath the skin (Lupariello et al., 2020).

In the state of Maryland, it is mandatory for registered nurses to report suspected child abuse based on professional judgment, even without proof, and any report made in good faith is immune from civil or criminal liability or penalty (MDHS, 2021). The process involves filing a report (DHR/SSA 180), notifying the local Child Protection Services department, and law enforcement (in the jurisdiction where the incident occurred) within 48 hours following a verbal report to the nursing supervisor. A copy of the DHR/SSA 180 form must also be forwarded to the State Attorney’s office, and the form should contain the name, age, and address of the child and the nature and extent of the abuse or neglect of the child.

References

American Academy of Pediatrics. (n.d.). Abusive head trauma (shaken baby syndrome). Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/aap-press-room-media-center/Pages/Abusive-Head-Trauma-Fact-Sheet.aspx#

Lupariello, F., Coppo, E., Cavecchia, I., Bosco, C., Bonaccurso, L., Urbino, A., Di Vella, G. (2020). Differential diagnosis between physical maltreatment and cupping practices in a suspected child abuse case. Forensic Sci Med Pathol. 16(1):188-190. doi: 10.1007/s12024-019-00155-w.