Clinical Application for Child Health Nursing NUR 327 Child Abuse Lecture 4-A.
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Transcript of Clinical Application for Child Health Nursing NUR 327 Child Abuse Lecture 4-A.
Clinical Application for Child Health Nursing
NUR 327
Child Abuse
Lecture 4-A
Types of Child Abuse
Neglect: Intentional or unintentional
omission of basic needs and support
Physical Abuse: Is non-accidental injury to a child
by an adult
Sexual Abuse: Forced involvement of children in
sexual activities by an adult
Emotional Abuse:Withholding of affection, use of cruel and degrading language towards a child by an adult
Child Abuse
Reports of violence against children has almost tripled since 1976.
Many of the abused children are infants.
NURSES ARE MANDATED NURSES ARE MANDATED REPORTERSREPORTERS
Child Abuse
Neglect Physical or emotional maltreatment Failure to thrive
Physical Abuse Minor or major physical injury (bruising,
burns, fractures) May cause death Shaken baby syndrome (SBS)
Sexual
Emotional May be suspected, but difficult to
substantiate Impairs child’s self-esteem and competence
Child Abuse
Warning Signs
Incompatibility between history of event and injuries
Conflicting stories from various people
involved
History inconsistent with developmental level of child
Repeated visits to emergency rooms
Inappropriate response from child and/or caregiver
Child Abuse
Nursing action
Assess: Physical assessment and history of event, observe and listen to caregiver’s and child’s verbal and non-verbal communication
Documentation: Contact Child Protective Services, hospital documentation
Support family and child: Social services, resources, teaching
THE CHILD’S SAFETY COMES FIRST AND IS THE PRIORITY!
Medication Administrationfor child
Lecture 4-B
Oral Medication
Hold infant with head elevated to prevent aspiration
Slowly instill liquid meds by dropper along side of the tongue
Crush pills and mix with sweet-tasting liquid if permitted, but don’t add too much liquid!
Allow choices for the child such as which med to take first
Flush following gastreostomy or NG tube
Factors to consider when selecting IM sites
Age Weight
Muscle development
Amount of subcutaneous fat
Type of drug
Drug’s absorption rate
IM and SQ Meds
Select needle length according to muscle size
• Use Z-track for iron and tissue-toxic meds •May mix medication with lidocaine
• Some medications may be need to be separated into 2 injections depending on amount
Peds IM Injection Sites
Vastus lateralis for infants
Ventrogluteal and dorsogluteal
Don’t inject into dorsogluteal until age 3 years - muscle not well developed until child walks and sciatic occupies a larger portion of the area.
Deltoid after 3 years
Vastus lateralis Site
Deltoid Site Ventrogluteal Site
Dorsogluteal Site
IV Meds
Site may be peripheral or central Administer IV fluids cautiously Always use infusion pumps with infants and small children Inspect sites frequently (Q 1-2 hours) for signs of infiltration Cool blanched skin, puffiness( infiltration) Warm and reddened skin (inflammation)
Nose Drops
Suction nare with bulb syringe prior to administration if nasal congestion
present
Ear Meds
Pull the ear down and back to instill eardrops in infants (↓3 years pull ↓)
•Pull the ear up and out to instill in older children (↑ 3 years pull ↑)
• Have medication at room temperature
The End