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Child Abuse Reporting and Family Resiliency Strategies in Nursing Care

Understanding child abuse and the importance of accurate documentation and reporting is vital for nurses. This guide covers key aspects of identifying and addressing abuse, fostering family education, and enhancing communication within the healthcare team. We emphasize the resilience of families and how nurses can assess strengths, set goals, and adapt to challenges. Additionally, we outline critical issues related to meningitis, encephalitis, and closed head injuries, providing essential information for effective nursing care and family support in emotionally taxing situations.

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Child Abuse Reporting and Family Resiliency Strategies in Nursing Care

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  1. Child Abuse • Box 16-12 Pg. 688 • Need to know S&S, accurate documentation & appropriate reporting • Collaborate with team • Protect child • Family education & support

  2. Communication Models • Permissive/Restrictive • Warmth/Hostility • Authoritarian/Dictatorial • Permissive/Laisse-Faire • Authoritative/Democratic

  3. Resiliency • McCubben-family stress involves need for adjustment & adaptation • Resilient families demonstrate commitment; good problem-solving & communication; take initiative, adapt, persevere & bounce-back • Nurses need to foster resiliency

  4. Nurses Roles • Assess family strengths/challenges • Set realistic goals • Allow periods of adjustment • Provide education & anticipatory guidance

  5. Meningitis • Inflammation of the meninges • Causes: bacterial & viral • Pathology: • A] enter thru bloodstream, then spreads thru CSF • B] trauma • C] neurosurgery • D] foreign body

  6. Vascular congestion edema, IICP, necrosis of cells, causes permanent brain damage & death • Complications: obstructive hydrocephalus, thrombi, abscesses,deafness, blindness & paralysis

  7. Meningococcal meningitis sepsis • Waterhouse-Friderichsen syndrome-disseminating intravascular coagulation [DIC] • Adrenal hemorrhage & purpura Pg. 1678 • Mortality is 90%

  8. Diagnosis: LP • clinical manifestations: fever, vomiting, opisthotonus, headache, altered sensorium, nuchal rigidity, Kernig’s sign, Brudzinski sign, petechial rash • Nsg Care: V/S. I&O, neurological assessment, isolate, meds, support

  9. Encephalitis • Inflammation of CNS • Direct invasion by virus or post-infectious involvement • Clinical manifestations similar to meningitis • Diagnoses-primarily based on symptoms • Treatment-symptomatic

  10. Closed Head Injuries • Brain injury, skull fractures & hematomas • Causes-falls, MVA’s, bicycle accidents, seizure disorders, gait instability, cognitive delays, poor judgment, alcohol & drug use

  11. Skull Fractures • Severity depends on velocity, force, mass, area of skull & age • Linear • Comminuted • Compound • depressed, • Basilar • Diastatic

  12. Acceleration/Deceleration & shearing results in damage

  13. Brain Injury: Hemorrhage • Epidural-rapid deteriorationdilated & fixed pupils, seizures, paralysis,  deep tendon reflexes, coma & brain herniation

  14. Subdural-within 48 hrs, more common than epidural • Headache, agitation, confusion, drowsiness •  LOC -Box 37-4 Pg. 1648 • IICP-Box 37-1 Pg. 1645

  15. Chronic-S&S appear at a later date • Subdural & subarachnoid hemorrhages may be sign of child abuse

  16. Cerebral Edema • Often with head injury • Pressure causes tissue anoxia • If unchecked leads to fatal anoxia or herniation • Box 37-5 Pg. 1669

  17. Glasgow Coma Scale • 3 part response: eye opening, verbal & motor • Score of 15 = unaltered • 8 or below = coma • Lowest 3 = coma or death

  18. Brain Death • Need complete cessation of clinical evidence of brain function & irreversibility of condition

  19. Pain Pg. 1047 • Complex assessment in children • Fallacies & Facts Box 26-7 Pg. 1049 • Pain Scales- Table 26-2 Pg. 1052 • Developmental Box 26-9 Pg. 1054 • Guidelines Pg. 1059 • Analgesics Pg. 1060-1066

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