Child Abuse

Physical Abuse

Any non accidental physical injury

Physical signs of abuse

• Unexplained injury

• Fading bruises/mark after absence from school

• Frightened of parents, cries when time to go home

• Shrinks at approach of adult

• Reports injury

• Abuses animals

Physical abuse may be suspected when the parent/caregiver…

• CONFLICTING, unconvincing, or no explanation for child’s injury

• Described the child negatively

• Hx of abuse as a child

Emotional abuse

Results in serious impairment (development) of the child’s social, emotional, or intellectual functioning

Examples of emotional injury

belittling or rejecting the child, ignoring the child, blaming the child for things over which the child has no control, isolating the child from normal social experiences, and using harsh and inconsistent discipline

Indicators of emotional abuse

• Extremes in behavior

• overly compliant, demanding, passive, aggressive

• Inappropriately adult/infantile

• DELAYED in physical/emotional development

• Suicide attempt

• Lack of attachment to parent

Physical Neglect

• Refusal of or delay in seeking healthcare

• abandonment

• expulsion from the home

• Refusal to allow a runaway to return home

• inadequate supervision

Emotional neglect

Failure to provide hope, love, and support (development)

Signs of Neglect

• Absent from school

• Beg/steals food or money

• Lack of medical care

• Dirty/body odor

• Lack sufficient clothes for weather

• Abuse of substance

Indicators of sexual abuse

• Difficulty sitting/walking

• Refusing to change for gym

• NIGHTMARES or BEDWETTING

• Change in appetite

• Unusual sexual knowledge

• Pregnant/STD

• Runs away

Major characteristic of abuser

Parents who abuse their children were likely abused as children themselves

Father dynamic in incestuous relationship

Domineering, impulsive, abusive

Mother dynamic in incestuous relationship

Passive, submissive, denigrates her role of wife and mother

• OFTEN AWARE → uses denial or keeps quiet out of fear

Adult survivor of incest

LACK OF TRUST

• Low lest-esteem

• Poor sense of identity

• Absence of pleasure with sexual activity

• Promiscuity

Outcome criteria for a child who has been abused

• Attend to injury

• TRUST in nurses → discuss abuse through PLAY THERAPY

• Decrease in regressive behavior

What is a potential nursing dx for a victim of child abuse?

Risk for delayed development

What is a method to gain the child’s trust as a nurse?

Use games or play therapy

Provide nonthreatening environment