Medications-Start IV access to administer IV isotonic-fluid boluses PRN isotonic saline of 20-60 mL/kg can go as high as 120mL/kg to rehydrate to therapeutic goal of fluid expansion (Djordjevic, Slavkovic, Marjanovic, and Zivanovic, 2015)Diagnostic tests ordered:Skeletal survey-first line and crucial in assessing child abuse cases (Jain, 2015)., CBC, UA, CMP, amylase, lipase,CT-imagining study of choice ( Djordjevic, Slavkovic, Marjanovic, & Zivanovic,2015)Consultation:Emergency consultation for surgery ( Djordjevic, Slavkovic, Marjanovic, & Zivanovic,2015)Parent Education: Educate mom on course of action and notification of child services protocol. Additionally, Explain to Tommy’s Mom in a non-confrontational tone, my role, and responsibilities in reporting suspected or actual child abuse to the proper authorities. It is also important to educateher that you are an advocate for the child (Kodner &Wetherman, 2013).Interventions to prevent child abuse in the primary care setting:Regularly assess child’s social function/historyAcknowledge the frustrations of parentingDiscuss coping strategies for colicky babies or crying a lot Recognize the increased risk of abuse of children with disabilitiesScreen for domestic/intimate partner violenceGuide parents in effective discipline strategies (Chung, Gubernick, LaNoue, & Abatemarco, 2019).Non-medication treatments:As soon as child emergency needs are metContact Police and Department of children and families to file abuse/neglect charges. Contact security for support. Daily weights. Follow-up: Revaluate frequently until stableSeek daycare or developmental program for tommy to attend-Tommy’s mom cannot afford daycare and has a high school diploma. She must rely on neighbors and her boyfriend to watch tommy- Children in poverty have higher rates of abuse/maltreatment (Landers, Carrese, & Spath, 2019)
Evaluation:Downs syndrome is one of the most common chromosomal disorders among humans. Its is estimated that one in every 700 birth is a downs syndrome baby. The risk for Downs syndrome increases as women age because the probability of splitting a chromosome increases (Matzan,2019). Children with disabilities are more likely to be abused and mistreated and represent10.4% of the population but account for more than ¼ of the child abuse/ mistreatment cases reported to child welfare services (Maclean, 2017). Additionally, children who are in poverty have higher rates of abuse and maltreatment as well (Landers, Carresee, & Spath, 2019). Tommy’s mom has a high school diploma and cannot afford day care, so she uses her neighbors and boyfriend to babysit. As primary care providers, we must continually evaluate for abuse/neglect by way of regular screenings and pediatric assessments. Health care providers are mandated by both state and federal government to report suspected child abuse/neglect. Being aware of what to look for is a crucial element in speaking up for these children who often are unable to speak up for themselves.
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- Summer '17
- NSG6435 Discussion