Emergency Department: Assessing Child Abuse and RN's Responsibilities

This assignment presents a scenario where a five-year-old child is brought to the emergency department with symptoms suggestive of potential abuse. The assignment requires the RN to assess the situation, considering factors like the child's behavioral changes, physical signs of injury, and the child's interactions with family members, particularly the uncle. The assessment approach is tailored to the child's developmental level, emphasizing the importance of involving the parents in the questioning process and creating a comfortable environment. The assignment highlights the need for a multidisciplinary team, including a doctor, child therapist, parents, and nurses. The RN's legal responsibilities are also discussed, which include reporting the suspected abuse to the physician and law enforcement, and contacting Child Protective Services. The assignment emphasizes the importance of recognizing the physical, emotional, and mental trauma associated with child abuse and the need for early intervention.

Discussion:
Abuse occurs in many areas of society, and it takes many forms. The situation of abuse may
involve child abuse by a parent or the caregiver. Abuse is related to being physical, it can also
include emotional torture, sexual abuse etc. This results in the health problem of the victims and
the victims suffers from physical and mental trauma.
In the given scenario the additional data regarding the potential abuse I would assess is if the
child is scared, if she is having difficulty walking or sitting comfortably or if she is getting
fearful if touched (Perkins, 2018). If she seems to be on high alert, if she is avoiding or trying to
avoid her Uncle, Does her bodies injury marks have a pattern. Further, some tests would be done
such as urinal tests & checking of other bruises in the body. (Pereda et al., 2009)
To assess this situation, the best part is to talk with the child and make her comfortable about the
situation. Being a 5-year-old child, the mental development is not much, she must be closest and
comfortable only with her parents, so we will need the parents to do the assessment, and we
would guide them on how to do it. They are the ones who will be asking relevant questions and
make the child comfortable for the physical tests to be done by the doctor.
The team members who are needed to be included in the process a doctor, a child therapist, The
parents and also other nurses who take care of the children. The doctor should do the basic and
necessary examination of the child and accordingly prescribe medication to help cure the fever.
The physical Bruises throughout the body must be checked by the parents, but the doctor should
prescribe medication so that it can be healed soon. The nurse should use antiseptic and assist the
doctor (Pereda et al., 2009)

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In a situation like this, the RN has some legal responsibilities. Initially, she should report it to a
physician or physician assistant. Post that she should inform the law enforcement at the earliest
before the victim leaves. Depending on the degree of impact of the abuse, she must call Adult
Protective Services or Child Protective Services and follow it up with a written report. (“What
Should a Nurse Do If They Suspect a Patient Is a Victim of Abuse?” 2018). She can also
participate in a sexual assault nurse examiner course and acquire some more evidence on child
sexual abuse. (Theodosios, 2019)
Child abuse is becoming an essential factor because the child suffers from trauma, whether it is
physical trauma, mental trauma or emotional trauma. If the child abuse is not dealt with
appropriately in the early stages, it leads to adverse effects in the mind of the children, and also
they suffer from anxiety, depression and a suspect of fear.

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References
Pereda, N., Guilera, G., Forns, M., & Gómez-Benito, J. (2009). The international epidemiology
of child sexual abuse: A continuation of Finkelhor (1994). Child Abuse & Neglect, 33(6),
331–342. https://doi.org/10.1016/j.chiabu.2008.07.007
Perkins, A. (2018). The red flags of child abuse. Nursing Made Incredibly Easy!, 16(2), 34-41.
doi: 10.1097/01.nme.0000529946.76463.6b
Theodosios, S. (2019). The role of the nurse in child sexual abuse in usa. Retrieved 28 August
2019, from http://www.hsj.gr/medicine/the-role-of-the-nurse-in-child-sexual-abuse-in-
usa.php?aid=3152
What Should a Nurse Do If They Suspect a Patient Is a Victim of Abuse? (2018, September 12).
Retrieved August 28, 2019, from https://www.registerednursing.org/what-should-nurse-
do-suspect-patient-victim-abuse/