1. Abuse in the Family
Chapter 8

2. 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

3. 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Child may be hyperactive, angry, exhibit antisocial personality, or may be withdrawn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

4. 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

5. 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

6. 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

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

8. 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

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

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

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

12. 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