Abuse in the Family Chapter 8

Child Abuse Not limited to one age group; can be detected at any age Highest number of victims is birth to 3 years of age Abusive parents found at all socioeconomic levels Mandatory reporting

Child Abuse: Effects on the Family Long-term as well as immediate effects Child may be hyperactive, angry, exhibit antisocial personality, or may be withdrawn Child may be removed from home or separated from the family for protection Cyclic from generation to generation

Physical Abuse Inexperience in addition to dysfunctional coping Physical punishment that leaves marks, causes injury, or threatens the child’s physical or emotional well-being Bruises that occur in areas of soft tissue may be suspect Spiral fractures, burns

Shaken Baby Syndrome Occurs when a small child is shaken by the arms or shoulders in a repetitive, violent manner Whiplash-type injury Edema to brain stem and retinal or brain hemorrhages Loss of vision, mental retardation, or even death may occur Clinical manifestations include lethargy, irritability, vomiting, and seizures CT or MRI

Munchausen Syndrome by Proxy One person either fabricates or induces illness in another to get attention Mother appears very attentive to the child Close observation of the caregiver’s interactions with child is necessary Caregiver needs psychiatric help

Emotional Abuse Verbal abuse Emotional unavailability Insufficient or poor nurturing or threatening to leave child Role reversal

Child Neglect Failure to provide adequate hygiene, health care, nutrition, love, nurturing, and supervision needed for growth and development Failure to thrive Be careful of unsubstantiated accusation of neglect

Sexual Abuse Incest The Federal Child Abuse Prevention and Treatment Act definition of sexual abuse Sexual assault

Nursing Process for the Child Who Is Abused Assessment Nursing diagnoses Outcome identification and planning Implementation Evaluation

Domestic Violence in the Family Effects on the family Children coping with domestic violence

Parental Substance Abuse Effects on the family The addicted parent is not dependable and cannot provide stability for the child Parent may waver between overindulgence and unreasonable and unpredictable behavior toward the child Children coping with parental addiction Behaviors in children include failing in school, unexcused absences, frequent minor complaints, stealing or committing acts of violence, aggressive behavior, and abuse of drugs and alcohol