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59 Cards in this Set
- Front
- Back
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What are the factors predisposing to physical abuse?
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parental characteristics (social isolation, young parents, single parents), characteristics of the child (disabled, preterm, under 3), environmental characteristics (divorce, poverty, unemployment, stress)
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What percentage of children are neglected by their parents?
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90%
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What are examples of physical neglect?
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deprivation of food, clothing. supervision, shelter, medical care and education
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What are examples of emotional neglect?
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lack of affection, attention and emotional nurtrurance
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What is emotional abuse?
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the deliberate attempt to destroy or significantly impair a child's self-esteem or competence
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What is physical abuse?
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deliberate infliction of physical injury on a child
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Shaken baby syndrome (SBS)
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caused by violent shaking of infants and young children
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Munchausen Syndrome by Proxy (MSBP)
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fictitous disorder by proxy or medical child abuse in which caretakers deliberately exaggerate or fabricate histories and symptoms or induce symptoms
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Sexual abuse definition
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use, persuasion, or coercion of any child to engage in sexually explicit conduct or simulation of such conduct for producing visual depiction of such conduct, or rape, molestation, prostitution, or incest with children
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What are the types of sexual maltreatment?
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incest, molestation, exhibitionism, child pronography, child prostitution, pedophilia
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Characteristics of abusers
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anyone can be a sexual abuser but a typical abuser is a male whom the victim knows
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Victims of sexual abuse
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come from all socioeconomic backgrounds
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Nursing care for the maltreated child
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identify abuse situations as eartly as possible, history pertaining to incident, evidence of maltreatment, protect child from further abuse
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Mortality =
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death
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Morbidity =
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illness
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What injuries are the leading cause of death in ages > 1 year?
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motor vehicle crashes, drowning, fires and burns, firearms, poisoning, falls, mechanical suffocation
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Childhood morbidity
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may denote acute illness, chronic disease, disability, diseases vary according to age, low-income children do not fare as well, specific groups of children have increased health problems
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Etiology of head injuries in children:
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falls, motor vehicle injuries, bicycle injuries
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Pathophysiology of head injury
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force of intercranial contents cannot be absorbed by skull and musculoligamentous support of head, child's response is different due to larger head size and insufficient musculoskeletal support
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Children are especially vulnerable to head injuries to what kind of injuries?
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acceleration-deceleration injuries
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Therapeutic management for cerebral trauma in child
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hospitalization if severe injuries, LOC for several minutes, prolonged or continuous seizures, NPO initially, possible surgical therapy, prognosis depends on extent of injury and complications
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Nursing care management
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frequent assessments (vital signs and neuro checks), provide analgesia and sedation, careful observation and recording, family support, rehab, preventions
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Drowning
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second leading cause of accidental death in children, death occurs from asphyxia submerged, can occur with even small quantity of water
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Near-drowning
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survived at least 24 hours after submersion
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Pathophysiology of drowning
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hypoxia, aspiration (asp. pneum is possible 2-3 days later), hyprothermia
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Prevention of drowning
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education is key!
adequate supervision |
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Irreversible brain damage can occur when in a drowning/near-drowning?
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4-6 minutes of submersion r/t decreased O2
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Cerebral recovery depends on what?
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effectiveness of initial resuscitation and subsequent critical care measures to support cerebral salvage
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Therapeutic management of drowning/near-drowning
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emergency resuscitative efforts at the scene, management based on degree of cerebral insult, aspiration is a frequent complication, prognosis depends on length of submersion in nonicy water for < 5 min and presence of sinus rhythm, reactive pupils and neuro responsiveness at the scene
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Nursing care management of drowning/near-drowning
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depends on condition of child, helping parents cope with feelings of guilt, helping with parental anxiety r/t prognosis, education on prevention of drowning
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s/s of corrosive poisonings
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severe burning pain in mouth, throat and stomach, white, swollen mucous membranes, edema of lips, tongue and pharynx, hemoptysis, drooling, shock, anxiety, agitation
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s/s of hydrocarbon poisonings
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gagging, choking, coughing, nausea, vomiting, lethargy, weakness, tachypnea, cyanosis, retractions, grunting
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s/s of acetaminophen poisoning
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occurs in 4 stages:
1. N, V, sweating pallor 2. patient improves 3. pain in RUQ, jaundice, confusion, stupor, coagulation abnormalities 4. patients who do not die in hepatic stage gradually recover |
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s/s of ASA poisoning
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nausea, disorientation, vomiting, dehydration, diaphoresis, hyperpnea, hyperpyrexia, oliguria, tinnitus, coma, convulsions
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s/s of iron poisoning
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occurs in 5 stages:
1. vomiting, hematemesis, diarrhea, hematochezia, gastric pain 2. patient improves 3. metabolic acidosis, fever, hyperglycemia, bleeding, shock, death (may occur) 4. hepatic injury, seizures, coma 5. rarely, pyloric stenosis |
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s/s of plant poisoning
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depends of type of plant ingested, may cause local irritation of oropharynx and entire GI tract, may cause respiratory, renal and CNS symptoms, topical contact can cause dermatitis
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emergency treatment of poisoning
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call poison control center, gastric lavage, activated charcoal
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Nursing interventions
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assess, prevention
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Educating on suffocation and choking
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keep all plastic bags stored out of child's reach, no pillows in cribs, removed bibs at bedtime, keep all latex balloons out of reach, remove all crib toys that are strung across crib or playpen, keep any small objects out of child's reach, no hard candy, nuts, hot dogs, popcorn
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Hot-water scalds are most frequent in which age group?
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toddlers
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Flame-related burns are more common in which age group?
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older children
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1 in 10 house fires are on account of:
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children playing with matches or lighters
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Child abuse and burns
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10-20% of documented cases of child abuse include burn injuries
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Characteristic of burn injury
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extent of injury described as total body surface area (use age-related charts), depth of injury, severity of injury
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First degree burn
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superficial (ie, sunburn)
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Second degree burn
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partial thickness (ie, scalds)
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Third degree burn
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full thickness (ie, fire)
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Fourth degree burn
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full thickness + underlying tissue
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Major burn injury
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treat in specialized burn center
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Moderate burn injury
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treat in hospital with expertise in burn treatment
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Minor burn injury
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treat in outpatient setting
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Emergency care priorities for burns
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stop burning process, assess victim's condition, cover burns to prevent contamination, transport child to appropriate level of care, provide reassurance
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First priority for burns
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airway maintenance
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Fluid replacement therapy
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critical in first 24 hours
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Nutrition for burns
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enhanced metabolic demands (increased calories and increased protein)
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Medications for burn patients
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antibiotics, analgesics, anesthetics for procedural pain
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Injury prevention
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provide safety education, develop long-term safety behaviors (ie, bike helmets), increase in pedestrian motor vehicle accidents (texting)
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Primary head injuries
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involves features that occur at time of trauma and secondary trauma
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Management of minor burns
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facilitate wound healing and prevent complications
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