Establish two large bore intravenous line: Administer IV isotonic-fluid boluses as needed. Complete primary (airway, breathing, circulation, disability, exposure) and secondary (head to toe exam) surveys. 2. Order additional diagnostic testing, including labs and imaging, as needed. 3. Obtain an emergent surgical consult. 4. Admit the patient to the ICU for further management. 5. Contact child protective services; contact police and social-work personnel. Follow up: Patient will follow up with a multidisciplinary team of nutritionist, psychologist, medical doctors, and social workers. *ALL references must be E v i d e n ce B a s ed ( EB)
Case Study Evaluation Child abuse is intentionally causing physical or mental harm to a child that may eventually lead to psychological and/or mental problems. Medical caregivers are the ones who pinpoint cases of abuse in children since those under the age of five cannot express themselves fully particularly in cases where they are abused. Children who are mentally or physically impaired are sally at a higher risk of being mentally or physically abused particularly due to the fact that they are unable to express themselves or report any incidences. Other factors that increase the likelihood of abuse in children include poverty, drugs, addiction, and even single parent-families. Medical practitioners may usually note any suspicious injuries that the child may have and report to child protection services who have the responsibility of ensuring the safety of all children (Friedman, 2015). Children have been known to die from extreme cases of abuse particularly where the caregiver is addicted to drugs and shoulders a lot of responsibility with limited income levels. In this particular case study, the mother took the child to hospital with claims that he had fallen from the bed where he was sleeping on his stomach. The child had refused to eat or drink anything after the fall despite the fact that he had been a very active and jolly child. The child is 26 months old and is known to be an active and happy child in spite his disability. The mother presented the child to the hospital with a round bruise on his stomach and reports that his urine was dark with a foul smell. Even though the mother claims that the child fell from the bed, the injuries are consistent with those of a punch. It is clear that a blunt object hit the child. When the child was examined physically, the doctor found bruises and scars, as well as injuries on his wrists that had been around for quite a while. There were also rib fractures. The child has been diagnosed with Down syndrome since birth which means that he is in need of ore specialized care. Besides, his nutritional needs have not been met hence the case of dehydration. This is most likely due to the low income and social isolation experienced by the mother. The mother smokes hence exposing the child to second-hand smoke and has a boyfriend who lives with them even though he is not the biological father of the children. The mother has other young children and does not
receive any support. Based on the lifestyle that the child is exposed to and the injuries on his body, it is clear that the child is physically abused and neglected ( Gershoff, et al., 2018). Physical abuse is indicated by the bone fractures, bruises and hematomas present on the child.
You've reached the end of your free preview.
Want to read all 8 pages?
- Summer '17
- NSG6435 Discussions