A Peer Response must be substantive by bringing information to the discussion or further enhance the discussion. DO NOT use of references. Word count is greater than 75 words or at least 5 sentences in length. Statements like “I agree” or “great post” does not count for the words or sentences.
Discussion question/Participation #1
Child abuse most commonly found in toddlers is neglect. Neglect can be intentional or unintentional. If the parent or childs provider is unaware they are causing possible harm, not providing enough supervision, food, clothing or hygiene is neglect. Neglect can be difficult to identity as this is not something always visible. Parents or guardians may be sick themselves and no longer able to care for the child as they normally would. Many children will think its normal to not have something until it is brought to their attention when they get older in school and begin relationships with their friends.
Physical abuse in toddlers: clues to look for would include injuries not consistent with the story being told, bruises with multiple stages of healing, delay to seek treatment, frequent ER/urgent care visits and verbalization from the child. Last year my youngest who just turned 5 she was 4 when she fell off her bunk bed hit her head, my husband took her to the ER as it was 2300 so urgent care was not open. She was telling everyone in the ER that she fell out of bed and hit her head, while she was playing and laughing. Long story short they asked my husband to step out of the room and they asked him what happened while at the same time they were asking her. When he went back into the room she she told the DR ” I say my DEEDEE, didn’t see me fall out”. She received 5 staples and came home with a mummy wrap on her head. My husband needless to say was impressed that the ER staff interviewed them both separately and the MSW was involved the whole time.
Emotional abuse in this age group is harder to detect as some toddlers are not mentally capable of understanding the language being spoken to them and are just learning to speak themselves. Some signs could include rejecting the child, withholding care/love, swearing/yelling at the child.
Cultural beliefs that are still practiced today could be considered child abuse. One example would be the practice of cupping. This is practiced in the middle east, eastern europe and asia. The use of cups are placed on the childs back to rid the body of toxins. (2017)
In the state of Missouri the reporting is required by all personal who are licensed healthcare professionals , police officers, social workers or chaplains. Anyone in the state of Missouri can report child abuse to the state hotline. With me being a hospice nurse our policy is to discuss with our social worker then report together. We can report anonymously if we feel the need and not report to our employer.
Discussion question/Participation #2
Abuse, maltreatment and neglect pose serious danger to the development and growth of children and a serious health concern affecting the society at large, according to world health organization (2020) over 300 million children aged 2-4 years endure physical or psychological abuse from care givers and their parents. children suffer from extreme stress from abuses which affect their mental,emotional and physical health which are exhibited through negative societal behaviors including depression, anxiety , PTSD, smoking and ETOH abuse, abnormal sexual behaviors. signs of most abuse are evident including unexplained cuts, bruises, fracture, sexual transmitted infection, children looking malnourished and unkempt, bleeding and laceration from sexual abuse, and recurrent hospitalization. some abuses are silent and takes appropriate health assessment to dictate, this includes verbal, psychological and emotional abuse, neglect and withdrawal of care (Center for disease control and prevention prevention, 2021) .
Culture influences and shapes how individuals experience child hood and how they raise children. Also culture determines of what is behaviors that acceptable and what constitutes child abuse, culture also plays a role in different forms of abuse witnessed today, especially African parents employ different methods including flogging, beating, verbal aggression and food denial as forms of punishment for child’s abnormal behaviors which can result in child’s injury, there is difficulty in reporting this type of gross abuse and maltreatment because of the belief they have that such crude methods are the best way to train a child, and the saying spare the rod and spoil the child. another clear example is female genital practiced in most African , middle east and Asian countries is a gross abuse but its part of what is acceptable due to their archaic culture according to world health organization (2021).
Discussion question/Participation #3
It is hard to fathom the thought of someone hurting an infant. Even more so a parent. However it does happen, and many times at least one of the parents is involved(Green,2018).A common form of abuse on infants is Shaking Baby Syndrome.
This type of abuse is when a baby is shaken severely,dropped or is thrown causing trauma to the brain. Signs and symptoms of this form of abuse include, decreased level of consciousness, seizures, extreme irritability, unequal size of pupils and inability to focus eyes or track movement.
Culture can play a large role in how one raises their children. Many states have recognized this, and in turn have incorporated that into their reporting statues. This was done so by adding a possible exemption to “cultural practices”. This is important as the United States has many refugees and residents from around the world. Practices that may be deemed socially acceptable or an everyday norm may be considered neglect or abuse here.
Arizona is a state that require anyone who is concerned or suspious of child abuse or neglect to make a report. However, there are specific careers in which the state identifies as mandated reporters.Failure to report, can lead to severe consequences. Of these careers nurses are mandates to report possible child abuse in patients.They can make this report by making an online report, calling the 24 hotline or speaking to a law official immediietly(Dianna M. Náñez, 2018). A nurse should never rely or assume anyone else will make the report. If one sees the report not being made they need to take it upon themself to complete the report. There are scales used within the medical setting that are prompted when certain words are entered in the medical chart. These scales can determine the risk of abuse and prompt the nurse to look out for any more signs of abuse (Green,2018)
Discussion question/Participation #4
The physical assessment of both a child and an adult start with building a rapport and trust with the nurse. For children, this involves the nurse talking and interacting with both the child and the child’s parent or caregiver.
The child could be fearful about the appointment and the nurse needs to be cheerful and kind and make the child feel safe. For an adult, a simple conversation with pleasantries and small talk can be used and for a child, explaining what you are doing before it’s done in simple terms may be helpful.
According to Falkner (2018), Gordon’s pattern of health perception differs from toddler to preschooler to the school age child. For the toddler, the concept of illness is basic, and they need warmth and encouragement. The nurse should get down to their level, show them instruments before they are being used, and say things in simple terms. The nurse could say something like, “let’s see how big you are” when having them step on the scale. The preschooler can realize that germs cause illness, and they need their parents’ comfort and support. One strategy I’ve seen before is telling the child “We’re going to give your arm a hug now” when checking their blood pressure. For the school age child, they can understand what causes a sickness, understand the need for medicine, and need their parents’ comfort and support. The nurse can have a conversation with this age child and explain things in simple terms, with the expectation that they will understand. It’s good to ask them questions about things they are interested in and get to know the child.
Discussion question/Participation #5
It is important for the consideration of age , growth an developmental difference between a child and adult in performing physical assessment. it is important to involve child’s parent during assessment in the room, introduce yourself, explain what you are going to do and gain consent from both the child and the parent with a nice voice in order to create calming and trusting atmosphere.
Creating a conducive environment plays an active role and engaging with the child utilizing playing or gaming to obtain the child’s cooperation and decrease fear, hence most children exhibit fear and anxiety in the presence of strangers. it is important also that an infant or toddler is incapable of communication therefore the parents will have to give detailed information during an assessment and to verify information given by the child with the parent. level of communication is also important hence the nurse must speck slowly and clearly using simple terms for child to understand. example is listening in place of auscultation, touching in place of palpation. performing assessment like auscultation on the parent will help allay fears about the procedure and will motivate the child to accept the procedure(Dersch-mills D. 2018).
Offering snacks that the child likes and keeping conversation about the child’s favorite shows helps to create wonderful bond and trust during the assessment , hence you like what they like, also getting them to help you during the assessment is another way to gain a child’s cooperation, they like to explores and interested in learning and playing with different toys and equipment, using the stethoscopes to listen to your heart first will give them the confidence they need. physical assessment remains the same both for a child and an adult but the strategies to obtain them is a little different, hence an adult can give detained health information, understand vocabulary and some medical terms. ensuring respect, privacy and dignity is important in carrying assessment regardless weather it is a child or an adult(Harlan et al, 2009).
Discussion question/Participation #6
Physical assessment has similarities between a child and an adult, including focusing on patients’ present illnesses and taking history. However, in adults, the head circumference is not taken as with children (Angelina, 2018).
In an adult also, you can address them typically using ordinary words and terms without requiring aid from an assist if the adult is well enough to talk (Fast, 2015). This is, however, different in children who need an adult to explain further their signs. The adult may be a caregiver or a parent who can explain the symptoms the child has been showcasing.
For nurses to communicate well with their junior patients, they have to modify the whole assessment process to create a proper communication pathway with the children (Angelina, 2018). A nurse can be interactive with the child to first gain trust before carrying out her assessments. The nurse can do this by letting the child play with her stethoscope while preparing them for a lung checkup.
The nurse can further create communication by first greeting the patient cheerfully before engaging their parents (Fast, 2015). This strategy will communicate to the children that the nurses are trustable people and there for a good purpose.
Being a pediatric nurse can be pretty challenging as the patient may refuse to comply with the assessment procedure, which requires a nurse to be considerate enough. That way, they can build trustable communication with their patient to ensure they let them proceed with the assessment.
