Maltreatment (Peds)

What is physical maltreatment?

pain or harm physically

What is sexual maltreatment?

Sexual contact w/o consent

What is emotional maltreatment?

Humiliating
Threatening
Intimidating

What is neglect?

Fails to provide…
-Physical Care (Feeding, Clothes, Medical Care)
-Emotional Care (Affection, Attention)

What are risk factors for maltreatment in caregivers?

Young age
Social Isolation
Low-Income
Lack of education
Lack of knowledge
Substance Use
Abuse hx
Lack of support

What age is at greater risk for maltreatment?

Child 1 year or younger

What infants/children are at risk for maltreatment?

Unwanted
Hyperactive
Disability
Premature (Bonding)

What are environmental risks for maltreatment?

Divorce
Stress
Unemployed
Crowded Living

What are indicators of abuse?

Physical evidence
Vague explanation
Other injuries not related
Delay in seeking care
Inconsistent story
Repeated injury
Inappropriate response

What shows physical negelct?

FTT
Lack of hygiene
Frequent injury
Dull affect
School Absent
Delay in care

What shows physical abuse?

Bruises (welts)
Multiple fractures
Burns
Fractures
Lacerations
Withdrawal
Aggression

What shows emotional neglect/abuse?

FTT
Eating disorder
Enuresis (Bed-Wetting)
Sleep Issues
Withdrawal
Extreme behaviors
Attempts suicide
Rejecting/Isolating

What shows sexual abuse?

Bruises
Bleeding (genitals/anus/mouth)
STI’s
UTI
Difficulty walking/standing
Withdrawal
Unusual body odor

What shows shaken baby or head trauma?

Vomiting
Resp Distress
Bulging fontanel
Hemorrhage
Seizure
Apnea
Bradycardia
Blindness
Bruising

What is required of all nurses?

Mandatory Reporting
Civil/Criminal Penalty for not

What does multiple bruising in different healing show?

ongoing beatings

How should interviews be done?

With child and parent separate

What kind of questions should be asked?

open-ended questions

What is Munchausen Syndrome by Proxy?

caregivers deliberately exaggerate or fabricate histories and symptoms or induce symptoms.

What are the parenteral characteristics of abuse?

Age
Substance Abuse

What are child characteristics of abuse?

Birth to 1 year old
Disability

What are environmental characteristics of abuse?

Low income
Frequent Relocation

Screened in

Formal report after investigation

Screened out

No evidence of maltreatment

victims

person maltreated

non-victims

at risk for harm in some way (sibling, etc)

More than 4/5’s of perpetrators

18-44 years of age

Under 18 in most states…

State limits publishing

What is maltreatment?

failure on caregivers end for child

Physical indicators of child of maltreatment

Low Weight
FTT
Poor hygiene
Inappropriate attire
Adult behavior

Behavioral Indicators of child maltreatment

Begs/Steals Food
Inconsistent School
Fatigue
Difficulty w/ relationships

Emotional Maltreatment signs

Extreme Behavior
Repetitive Behavior
Suicidal Ideations

What does AHT (Shaken Baby) present as?

Intracranial Bleeding
Retinal Hemorrhage
Rib Fracture
Edema

What is human trafficking?

recruiting/harboring/transporting for commercial sex acts

What is an indicator on children for trafficking?

tattoos and scripted responses

What is factitious disorder?

falsification of symptoms (used to be Munchausen syndrome by proxy)

Common factitious disorders

Seizure
N+V
Altered LOC

What are nurses with maltreatment or abuse?

mandatory reporters (contact provider, no proof needed)

What to avoid when talking about abuse?

Promises
Leading language
Accusations

What is important that the nurse should do with discharge?

Not the child’s fault
Say they will be safe
Wait for someone to talk to child (play until…)

What can happen with human trafficking?

bonding