Child Abuse (Nursing)

00:01 So let's start with Physical Abuse in Pediatrics.

00:05 Who are the risk factors? What are the risk factors? We know that we are looking at the personality types and we are looking at different circumstances.

00:14 And one of the circumstances that we are looking at is parents: that are young and immature. Your teenage parents younger parents that may be didn't get to finish high school, or finish college.

00:26 Look at those parents. Parents with unemotional needs: Again if they weren't emotionally taking care of as children you can kind of pick out those people that are always wanting the attention to themselves.

00:40 Economics plays a big part. But don't always assume that low social-economics are the abusers; because, we also know that higher economic families also have abusing their families.

00:53 Domestic violence: Always be watching for signs and symptoms of that.

00:57 Parental mental health issues: We have a lot of people that are undiagnosed mental health issues. So again be looking for signs and symptoms in those parents and how they are treating their children.

01:10 Substance abuse is always at the top. Whether it's adult abuse or whether it's pediatric abuse. Again people that are abusing on substances whether be alcohol, whether be drugs are more prone to cause physical abuse to their children.

01:26 And then, chronically ill children.

01:28 Be thinking about your families that are taking care of chronically ill children, special needs children, and the stress that goes along with that.

01:35 Not only the physical and emotional but financial stress.

01:39 Keep an eye on those families as well.

01:42 Because we know that just the stress can lead to abuse.

01:46 Children with ADHD or ODD: Again remember children that behaviorally cause stress to the family be looking for signs and symptoms of an inappropriate discipline.

01:58 Or may be where the parent just had it.

02:01 Again if you pick up on those signs and symptoms we can keep our children safe.

02:06 and recognize them at a earlier risk/time.

02:13 Another risk factor is when there is no biological father present or mom has brought in a boyfriend.

02:19 It doesn't take much to watch the news to know that these two risk factors usually play a part in abuse. So again be asking about the socialness of the family.

02:31 Who is with the children? Who watches the children? Is mom at home? Is the boyfriend taking care of children a lot? Again not necessarily meaning that abuse is going on but as a nurse if you are always keeping that in the back of your mind you been able to pick up on those signs and symptoms a lot faster.

02:49 So assessment clues. How do i know? Most of times kids aren't necessarily gonna just come right out and tell you elders that are being abuse aren't just necessarily gonna come out tell you out of fears and embarrassment.

03:03 So as a nurse review the signs of what you are looking for in these kids.

03:07 So delay in seeking medical care.

03:10 You have a patient that comes in and they are very very checking you. If something is telling you "why didn't the parents bring them in earlier?" Make a note of that and do some investigation.

03:20 If they have their stories that don't match up, is what i am trying to say.

03:27 You know moms tell a story. Dad tells a story. The child tells a story When those stories don't match up as to how injuries happened.

03:35 Or why they didn't come to the hospital earlier? Make sure you document that and take note of that.

03:41 What about frequent injuries? Be looking at old bruises, new bruises.

03:46 Is there a pattern of how many times they have been in the ER? Is there a pattern by many times they have been to the doctor's offices with stitches and those kind of things? And then again look at the reasons. Go back and read histories as to what the reasons why its behind the injury.

04:04 Withdrawn children: We known most children are afraid of strangers and that's the way it should be. But you should be able to tell as a nurse on whether a child is just being withdrawn? Or whether they are afraid because you are a medical person? Be looking at those kids who sleep up into the corner. They don't talk. They coward down when the parents talk to them and pick up on those sings as well.

04:30 Non-coping behaviors in children: You have elder children that they have temper tantrum they kept in-scream. But might be an inappropriate for what's going on.

04:40 Take not of those situations as well.

04:43 Children that won't look at their parents when they are with them, don't make eye contact with the parents.

04:48 They don't look to their parents for comfort.

04:50 Those are all signs and symptoms.

04:53 Again we talked about bruises, looking for old and new bruises.

04:57 Suspicious burns or suspicious pattern injuries: Again i know you learned in pediatric to look for patterns of injury and does it look like something.

05:08 Again and being able to talk to the child and being able to investigate what's going on.

05:14 We will help that child and we may be saving their lives.

05:18 So being able to pick up on those sudden signs and symptoms as a nurse is our responsibility.

05:24 And then looking at when you talking about, you know, "what happened?".

05:29 Is the parent always blaming another child? And again we all know that children play.

05:36 Children bite each other.

05:38 But you should be able to pick up on to the subtleties of what the parents saying and what the child saying.

05:43 And to be to do a good nursing assessment and be able to document everything so that you have a good record of what's going on.