Nursing approach to the evaluation of child maltreatment / Eileen R. Giardino, Angelo P. Giardino.

Format:

Book

Author/Creator:

Giardino, Eileen R.

Contributor:

Giardino, Angelo P.

Language:

English

Subjects (All):

Child abuse.

Nursing.

Child Abuse--diagnosis.

Mandatory Reporting.

Nurse's Role.

Nursing Assessment--methods.

Physical Examination--methods.

Social Responsibility.

Medical Subjects:

Child Abuse--diagnosis.

Mandatory Reporting.

Nurse's Role.

Nursing Assessment--methods.

Physical Examination--methods.

Social Responsibility.

Physical Description:

xxvii, 480 pages : illustrations (chiefly color), forms ; 26 cm

Edition:

First edition.

Place of Publication:

St. Louis : G.W. Medical Pub., [2003]

Contents:

Chapter 1 The Problem of Child Abuse and Neglect 1

Fatalities 1

Children With Disabilities 4

Costs of Maltreatment 4

Categories of Maltreatment 6

Physical Abuse 6

Sexual Abuse 6

Emotional and Psychological Abuse 8

Child Neglect 8

Legal, Institutional, and Personal Definitions of Abuse 9

The Child Abuse Prevention and Treatment Act 9

The Impact of Physical Abuse and Neglect 10

Conceptual Frameworks 10

The Epidemiological Framework 11

The Ecological Framework 11

Longitudinal Progression Model for Child Sexual Abuse 11

Engagement Phase 12

Sexual Interaction Phase 12

Secrecy Phase 12

Disclosure Phase 12

Retraction Phase 13

Traumagenic Dynamics Model for Child Sexual Abuse 13

The Role of the Nurse in Child Abuse and Neglect 15

Mandated Reporting 15

Dealing With Child Maltreatment 15

Research Perspectives on Child Abuse and Neglect 16

Chapter 2 Presentation and Overview of the Evaluation of Child Maltreatment 21

Overview: Presentations and Evaluation 22

Physical Abuse 22

Differentiating Accidental From Inflicted Injuries 24

Bruises 25

Burns 27

Skeletal Fractures 30

Central Nervous System Injury 33

Child Fatality 34

Sexual Abuse 36

Nonspecific Behavioral Complaints 38

Nonspecific Genital Complaints 39

Neglect 42

Provisional Neglect 43

Developmental Neglect 43

Supervisional Neglect 44

Part 2 Healthcare Evaluation

Chapter 3 History and the Healthcare Interview 49

History and Interviewing in Cases of Suspected Physical Abuse or Neglect 50

Warm-up and Ground Rules 51

Specific History of Injury 52

Neglect 53

History and Interviewing in Cases of Suspected Sexual Abuse 54

Obtaining Information From Caregivers 55

Gathering Medical History From the Child 58

Establishing Rapport 58

Eliciting General Health Concerns 60

Inquiring About Sexual Abuse 61

Providing Closure 62

Developmental Considerations 63

Questioning Preschool-Age Children 63

Questioning School-Age Children 64

Questioning Adolescents 64

Documentation 65

Taking Action 66

Chapter 4 The Physical Examination in the Evaluation of Suspected Child Maltreatment: Physical Abuse and Sexual Abuse Examinations 69

Evaluation Versus Investigation 71

The Physical Examination in Child Maltreatment Evaluations 72

Professional Knowledge About Child Abuse Evaluations 73

Stress and Distress Regarding the Evaluation 74

Inspection of Child's General Appearance 75

Specific Issues Related to the Examination for Suspected Physical Abuse 75

Accidental Versus Inflicted Injury 75

Skin Injuries 76

Bruising 77

Physical Examination of Bruises 77

Patterned Injuries 78

Dating of Bruise Injuries 79

Related Injuries 79

Burns 80

Pathophysiology 80

Relationship of History to Physical Examination of Burns 81

Characteristics of the Burn: Accidental Versus Inflicted 82

Skeletal Injuries 87

Relevant History 88

Patterns of Fractures in Abuse 88

Radiographic Evaluation 89

Guidelines for Imaging 90

Thoracic and Abdominal Injuries 90

Evaluation and Treatment 90

Examination of the Head 91

Basic Types of Head Injuries 91

Shaken Baby Syndrome 93

Presenting Signs and Symptoms 94

Physical Examination 95

Radiographic Evaluation of Head Injury 96

Mouth and Teeth 96

Poisoning 96

Physical Examination 97

Sexual Abuse Evaluation 97

Time Frame for Forensic Examination in Sexual Abuse 103

Examination Within 72 Hours 103

Examiner Expertise With the Sexual Abuse Examination 104

Knowledge Base of Practitioners in Child Sexual Abuse Findings 104

Stress With Sexual Abuse Evaluations 105

Setting 105

Preparing the Child for the Interview and Physical Examination 106

Use of a Colposcope in the Anogenital Examination 107

Position for Genital Evaluation 107

Anatomy and Terminology in Child Sexual Abuse 108

Genital Examination 109

Evaluation of the Hymen 112

Rectal Examination 114

Differential Diagnoses for Child Sexual Abuse 115

Appendix I Genital Evaluation Protocol Script 120

Appendix II Genital Examination Distress Scale 123

Appendix III Abuse and Neglect Forms 124

Chapter 5 Laboratory Findings, Diagnostic Testing, and Forensic Specimens in Cases of Child Sexual Abuse 137

Evidence Collection 138

Evidence Collection Kits 138

Clothing 139

Evidence Present on the Skin 140

Oral, Anal, and Vaginal Specimens 141

Blood Specimens 142

Hair Samples 142

Identification of Motile Sperm 142

Bite Marks 143

Forensic Photography 144

Forensic Colposcopic Photography 146

Chain of Custody 148

Laboratory Testing of Evidence 148

Detecting the Presence of Seminal Fluid 149

Blood and Saliva 150

DNA Profiling 150

Collecting Samples for Sexually Transmitted Disease Testing 150

Gonorrhea 151

Chlamydia 152

Herpes Simplex 152

Serology Testing 152

Appendix Evidence Collection and Forensic Photography 153

Chapter 6 Sexually Transmitted Diseases in the Setting of Maltreatment 159

When to Test for STDs in the Setting of Suspected Maltreatment 164

Asymptomatic Versus Symptomatic Infections 167

Specific Infections 168

Bacterial Vaginosis 168

General Overview and Epidemiology 168

Clinical Findings 170

Diagnosis 170

Treatment and Follow-up 171

Chlamydia 177

General Overview and Epidemiology 177

Symptoms 178

Prepubertal Children 178

Adolescents 178

Clinical Findings 179

Prepubertal Children 179

Adolescents 179

Diagnosis 180

Prepubertal Children 180

Adolescents 180

Treatment and Follow-up 180

Gonorrhea 180

General Overview and Epidemiology 180

Symptoms and Clinical Findings 183

Prepubertal Children 183

Adolescents 183

Diagnosis 184

Treatment and Follow-up 184

Pelvic Inflammatory Disease 185

General Overview and Epidemiology 185

Clinical Findings 185

Diagnosis 185

Treatment and Follow-up 185

Human Papillomavirus 188

General Overview and Epidemiology 188

Clinical Findings 189

Prepubertal Children 189

Adolescents 190

Diagnosis 191

Treatment and Follow-up 191

Herpes Simplex Virus 192

General Overview and Epidemiology 192

Clinical Findings 192

Prepubertal Children 194

Adolescents 194

Diagnosis 195

Treatment and Follow-up 195

Trichomoniasis 196

General Overview and Epidemiology 196

Clinical Findings 198

Prepubertal Children 198

Adolescents 198

Diagnosis 198

Treatment and Follow-up 199

Pediculosis Pubis 199

General Overview and Epidemiology 199

Clinical Findings 199

Diagnosis 200

Treatment and Follow-up 200

Syphilis 200

General Overview and Epidemiology 200

Clinical Findings 201

Diagnosis 202

Treatment and Follow-up 203

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome 205

General Overview and Epidemiology 205

Clinical Findings 209

Diagnosis 209

Treatment and Follow-up 209

Hepatitis B Virus 209

General Overview and Epidemiology 209

Symptoms and Clinical Findings 210

Diagnosis 210

Treatment and Follow-up 210

Chapter 7 Differential Diagnosis: Conditions That Mimic Child Maltreatment 215

Physical Abuse 216

Bruising 216

Actual Bruising 216

Accidental Bruising 216

Folk Remedies 216

Disorders of the Hemopoietic System 218

Vasculitis 219

Pseudobruising 219

Birthmarks 219

Dermatological Conditions 219

Toxins 220

Burns 220

Accidental Burns 221

Scalds 221

Patterned Burns 221

Pseudoburns 221

Infections 221

Chemical Irritants 221

Fractures 223

Accidental Injury 223

Birth-Related Fractures 223

Inherited/Metabolic Disorders 226

Infections 227

Eye Injuries 227

Retinal Hemorrhages 227

Retinal Hemorrhage From Birth Trauma 230

Trauma 230

Infections 230

Hematological Disorders 230

Metabolic Disorders 230

Intracranial Lesions 230

Subconjunctival Hemorrhages 230

Periorbital Bruising 231

Failure to Thrive and Growth Failure 231

Growth Variations 232

Congenital Anatomical Anomalies 233

Congenital and Chromosomal Disorders 233

Organ System Disorders 233

Cardiovascular System 233

Endocrine System 233

Gastrointestinal System 234

Hematological and Oncological Disorders 234

Immunological System 234

Metabolic Disorders 234

Renal System 235

Respiratory System 235

Sexual Abuse 235

Genital and Anal Findings 235

Anogenital Erythema, Excoriation, and Pruritus 236

Local Irritation 236

Dermatological Disorders 237

Infections 237

Systemic Conditions 238

Anogenital Bruising 238

Local Injury 238

Dermatological Disorders 238

Systemic Conditions 240

Anogenital Bleeding and/or Bloody Vaginal Discharge 240

Local Irritation 240

Dermatological Disorders 240

Infection 240

Endocrinological Disorders 240

Structural/Neoplastic Disorders 242

Nonbloody Vaginal Discharge 242

Unusual Anogenital Appearance, Acquired and Congenital 242

Acquired Conditions 242

Congenital Conditions 243

Chapter 8 Clinical Aspects of Child Neglect 251

Definition and Conceptual Models 255

Incidence Statistics 264

Nursing as a Basis for Clinical Practice With Child Neglect 265

Neglect in the Healthcare Setting 266

Presentation 266

Physical Neglect 266

Medical Neglect 267

Failure to Thrive 267

Evaluation 268

Generic Screening 270

Specific Screening 270

Physical Neglect 270

Medical Neglect 271

Failure to Thrive 274

Treatment 276

Generic Measures 276

Specific Measures 277

Nursing Interventions for Child Neglect 278

The American Nurses Association 279

Appendix Report of Suspected Neglect Form 280

Chapter 9 Documentation of the Evaluation in Cases of Suspected Child Maltreatment 289

General Considerations for the History and Physical Examination 289

Documentation Guidelines 290

Documentation of Consent 291

Format of Assessment Documentation 291

Documentation of Taped Interviews 292

Documentation of the History 292

History From the Caregiver 293

Documenting Neglect 293

Documenting Caregiver-Child Interactions 294

Physical Findings 294

Photographic Documentation of Findings 294

Use of Colposcope 299

Forensic Evidence Collection 299

Documenting Conclusions, Opinions, or Diagnoses From the Medical Evaluation 299

Documentation of the Treatment and Plan 300

Reporting Requirements 300

Court Testimony and Documentation 302

Depositions 302

Appendix Child Abuse Evaluation Form 303

Part 3 Related Issues

Chapter 10 Mental Health Aspects of Child Survivors of Abuse and Neglect 309

Historical Perceptions 311

Stereotypical Beliefs 312

Perceptions of Child Abuse 313

Social Perceptions 313

Mental Health Principles to Keep in Mind During the Abuse Evaluation 313

Points to Remember During History Taking 313

Points to Remember During Physical Evaluation 316

Developmental Level 317

Family Structure 317

Lack of Resources 318

Trauma Response Patterns 318

Emotional and Behavioral Aspects: Attempts at Mastery and the Compulsion to Repeat the Trauma 318

Posttraumatic Stress Disorder 318

Emotional and Behavioral Presentations 321

Integration 322

Reenactment 322

Repetition 322

Displacement 322

The Issue of Belief 323

Interventions 323

Short-Term Goals 323

Long-Term Goals 324

Chapter 11 Sexual Abuse of Adolescents 331

Epidemiology 331

Sexual Maturity 331

Adolescent Risk-Taking Behaviors 332

Dating Violence 334

Sexual Abuse of Males 335

Medical Evaluation of Acute Sexual Assault 335

History and Interview 338

Physical Examination 339

Documentation 340

Laboratory Evaluation 340

Forensic Evidence Collection Kit 341

Sexually Transmitted Disease Prophylaxis 341

Pregnancy Prophylaxis 342

Medical Evaluation of Nonacute Sexual Abuse 343

Sequelae of Sexual Abuse 343

Prevention and Anticipatory Guidance 346

Chapter 12 Munchausen Syndrome by Proxy 349

History 349

Victim and Perpetrator Classification 350

Medical History 350

The Multidisciplinary Team Approach 351

Documentation 352

Hospitalization 353

Covert Video Surveillance 353

Parental Profiles 357

Outcomes 358

Chapter 13 Child Protective Services and Child Abuse 361

The History of Child Abuse and Neglect Policy 361

Child Protective Services 363

Role of CPS in the Investigation of Child Abuse 364

Collaboration in the Investigative Process 365

Models of Collaboration in Child Abuse Investigation 365

Child Advocacy Center Joint Investigations 366

Child Abuse Reports 367

Sources of Reports 370

Process of a Child Protective System Case 371

Family Assessment 371

Case Planning 372

Case Management and Treatment 374

Evaluation of Family Progress and Case Closure 374

CPS and Mandatory Reporting 376

What to Report 378

Benefits of Reporting 379

Outcomes of CPS Interventions 380

Chapter 14 Legal Issues 385

Mandated Reporting 385

Criminal Investigation Process 389

The Judicial Setting: Juvenile, Domestic Relations, Criminal, and Civil Courts 390

Juvenile and Child Protection Courts 391

Domestic Relations Court (Family Court) 392

Criminal Court: Prosecutions 394

Civil Court: Lawsuits 395

Children as Witnesses 395

Professionals in Court as Witnesses 396

Appendix Mandatory Reporters, Statutes at-a-Glance 400

Chapter 15 The Relationship Between Domestic Violence and Child Maltreatment 411

Domestic Violence 412

Child Abuse and Maltreatment 412

The Link Between Domestic Violence and Child Maltreatment 413

Family Stressors in the Violent Home 414

Response Patterns of Children in Violent Homes 415

Physical Response 415

Cognitive Response 416

Psychosocial Response 416

Behavioral Response 417

Implications for Nursing Practice 417

Pediatric Nurses 418

Women's Health Nurses 418

Chapter 16 Risks to Children in the Digital Age 429

Technology and Its Use in Child Sexual Victimization 429

What Exactly Are the Risks? 430

Why Are Children Attracted to the Internet? 431

The Technological Generation Gap 435

How the Internet Can Be a Potentially Dangerous Place: Predators on the Web 435

Traders 435

Travelers 436

A Traveler Case Example 437

Case Study Analysis 438

What Can Nurses and Health Professionals Do to Minimize Risks? 439

Filters 439

Awareness and Risk Assessment 440

How to Handle Disclosure of Online and Offline Victimization 441

What to Do If You Suspect Online Victimization 441

Chapter 17 Prevention of Child Abuse and Neglect: Approaches and Issues 445

Overview of Prevention 445

Primary Prevention: Increasing Awareness 446

Secondary Prevention: Nursing's Role in the Detection of Abuse 446

Tertiary Prevention: Helping Those Already Harmed 447

Child Abuse Prevention Strategies for Children, Adults, and Nursing Professionals 447

Child-Focused Abuse Prevention Programs 447

School-Based Prevention Programs 448

Adult-Focused Prevention Programs 448

Home Visiting Programs 449

Pregnancy and Abuse 451

Professional-Focused Prevention Programs 451

Mandated Reporting of Abuse 451

Abuse Prevention 452

School Nurses 452

Nurses as Collaborators on the Healthcare Team 452.

Notes:

Includes bibliographical references and index.

ISBN:

1878060511

OCLC:

52166408