00:01
So let's start with
Physical Abuse in Pediatrics.
00:05
Who are the risk factors?
What are the risk factors?
We know that we are looking
at the personality types
and we are looking at
different circumstances.
00:14
And one of the circumstances that we
are looking at is parents: that are young
and immature. Your teenage parents
younger parents that may be didn't get
to finish high school, or finish college.
00:26
Look at those parents. Parents
with unemotional needs:
Again if they weren't emotionally
taking care of as children
you can kind of pick out those people that are
always wanting the attention to themselves.
00:40
Economics plays a big part.
But don't always assume that
low social-economics are the abusers; because,
we also know that higher economic
families also have
abusing their families.
00:53
Domestic violence: Always be watching
for signs and symptoms of that.
00:57
Parental mental health issues:
We have a lot of people
that are undiagnosed
mental health issues. So again be looking
for signs and symptoms in those parents
and how they are treating their children.
01:10
Substance abuse is always at the top.
Whether it's adult abuse or whether it's
pediatric abuse. Again people that are
abusing on substances whether be
alcohol, whether be drugs are more prone
to cause physical abuse to their children.
01:26
And then, chronically ill children.
01:28
Be thinking about your families
that are taking care of
chronically ill children, special needs children,
and the stress that goes along with that.
01:35
Not only the physical and
emotional but financial stress.
01:39
Keep an eye on those
families as well.
01:42
Because we know that just
the stress can lead to abuse.
01:46
Children with ADHD or ODD:
Again remember children
that behaviorally
cause stress to the family
be looking for signs and symptoms
of an inappropriate discipline.
01:58
Or may be where the
parent just had it.
02:01
Again if you pick up on
those signs and symptoms
we can keep our children safe.
02:06
and recognize them at
a earlier risk/time.
02:13
Another risk factor is when there is
no biological father present or
mom has brought in a boyfriend.
02:19
It doesn't take much to
watch the news to know
that these two risk factors
usually play a part
in abuse. So again be asking about
the socialness of the family.
02:31
Who is with the children? Who watches the
children? Is mom at home? Is the boyfriend
taking care of children a lot?
Again not necessarily meaning
that abuse is going on
but as a nurse if you are always keeping
that in the back of your mind
you been able to pick up on those
signs and symptoms a lot faster.
02:49
So assessment clues. How do i know?
Most of times kids aren't necessarily
gonna just come right out and tell you
elders that are being abuse aren't
just necessarily gonna come out
tell you out of fears and embarrassment.
03:03
So as a nurse review the signs of what
you are looking for in these kids.
03:07
So delay in seeking medical care.
03:10
You have a patient that comes
in and they are very very
checking you. If something is telling you
"why didn't the parents bring them in earlier?"
Make a note of that and
do some investigation.
03:20
If they have their
stories that don't match up,
is what i am trying to say.
03:27
You know moms tell a story. Dad tells
a story. The child tells a story
When those stories don't match
up as to how injuries happened.
03:35
Or why they didn't come
to the hospital earlier?
Make sure you document that
and take note of that.
03:41
What about frequent injuries?
Be looking at old bruises, new bruises.
03:46
Is there a pattern of how many
times they have been in the ER?
Is there a pattern by many times they
have been to the doctor's offices
with stitches and those kind of things?
And then again look at the
reasons. Go back and read
histories as to what the reasons
why its behind the injury.
04:04
Withdrawn children: We known most
children are afraid of strangers
and that's the way it should be. But
you should be able to tell as a nurse
on whether a child is
just being withdrawn?
Or whether they are afraid because
you are a medical person?
Be looking at those kids who sleep up
into the corner. They don't talk. They
coward down when the parents talk to them
and pick up on those sings as well.
04:30
Non-coping behaviors in children:
You have elder children that they
have temper tantrum they
kept in-scream. But might be an
inappropriate for what's going on.
04:40
Take not of those situations as well.
04:43
Children that won't look at their
parents when they are with them,
don't make eye contact with the parents.
04:48
They don't look to
their parents for comfort.
04:50
Those are all signs and symptoms.
04:53
Again we talked about bruises,
looking for old and new bruises.
04:57
Suspicious burns or suspicious
pattern injuries: Again
i know you learned in
pediatric to look for
patterns of injury and
does it look like something.
05:08
Again and being able to talk
to the child and being able
to investigate what's going on.
05:14
We will help that child and
we may be saving their lives.
05:18
So being able to pick up on
those sudden signs and symptoms
as a nurse is our responsibility.
05:24
And then looking at when you talking
about, you know, "what happened?".
05:29
Is the parent always
blaming another child?
And again we all know
that children play.
05:36
Children bite each other.
05:38
But you should be able to pick up on
to the subtleties of what
the parents saying and
what the child saying.
05:43
And to be to do a
good nursing assessment
and be able to document everything so that you
have a good record of what's going on.