Pease!!! I need your help!!!! Case study: Child Maltreatment

[toylover]

Hi All!

I'm a nursing student who is taking a pediatric class.

My professor gave one case study during the class and asked to think about questions that will be discussed in the next class. However, I don't know what interventions I should do as a nurse. So,is there someone can help me? Please.....!!!:heartbeat

Case Study 1: Olivia

You are a nurse working in the Emergency Department on a hot, humid day in July. At around 1100, the paramedics rush in with an 8 month old girl, Olivia. She is not breathing. Core temperature is > 41° C. They tell you Olivia was found by a passerby who noticed her in her car seat in her parents' SUV. Emergency crew at the scene had to break the window to get her out...they estimate the temperature inside the vehicle was well over 120 degrees. A few minutes later, Olivia's parents come rushing in. They are tearful and frantic. Both parents tell you that they thought the other parent had dropped the baby off at daycare.

Case Study 2: Aiden

You are the charge nurse working in the Emergency Department on a busy Friday night. A young couple brings in their 6-week-old infant, Aiden. The child is unconscious and barely breathing. Aiden has bruising behind his ears and his pupils are unequal. The parents tell you their child rolled off the couch onto the floor. They report he was fine after the incident, although he "cried really hard." Now, 3 hours later, they say he "became sleepy and now we can't seem to wake him up."

Questions:

1. Is this a case of child maltreatment? Provide evidence to support your decison.

2.How might you,as a nurse, be involved in this situation? Desribe.

3. What interventions would you, as the nurse, do in this situation? why?

[~Mi Vida Loca~RN, ASN, RN]

I am not a nurse so I can't answer you questions, but I answered them in my head and am curious to see what the answers are.

[Sarah13]

Hi! I am certainly no expert as to what medical interventions should be carried out but in case 1, there is obvious neglect by atleast one of the parents as the child had been left on its own. After consulting your senior member of staff, it should lead to an investigation, so therefore, this will involve the Police and social services child protection. Possibly the same for case 2, you would keep in mind that it could be maltreatment and the professionals in that department will hopefully get to the bottom of it. It is not our job to investigate but to gather the basic info, inform the right people and pass on what we can. Hope this helps.

[BabyLady, BSN, RN]

Sounds like homework....if you go through your textbook or do a google search...you should find information for your state about being a mandated reporter.

Generally, you'll receive more help if you show what work you have done so far.

Instructors generally don't give you case studies and nothing to go on....they usually assign reading and you use the case studies to show you understood the reading.

[Daytonite, BSN, RN]

case study 1: olivia

you are a nurse working in the emergency department on a hot, humid day in july. at around 1100, the paramedics rush in with an 8 month old girl, olivia. she is not breathing. core temperature is > 41° c. they tell you olivia was found by a passerby who noticed her in her car seat in her parents' suv. emergency crew at the scene had to break the window to get her out...they estimate the temperature inside the vehicle was well over 120 degrees. a few minutes later, olivia's parents come rushing in. they are tearful and frantic. both parents tell you that they thought the other parent had dropped the baby off at daycare.

• http://kidshealth.org/parent/fitness/problems/heat.html - heat illness
  
• http://www.emedicinehealth.com/heat_exhaustion_and_heat_stroke/article_em.htm - heat exhaustion and heat stroke
  

case study 2: aiden

you are the charge nurse working in the emergency department on a busy friday night. a young couple brings in their 6-week-old infant, aiden. the child is unconscious and barely breathing. aiden has bruising behind his ears and his pupils are unequal. the parents tell you their child rolled off the couch onto the floor. they report he was fine after the incident, although he "cried really hard." now, 3 hours later, they say he "became sleepy and now we can't seem to wake him up."

• http://kidshealth.org/parent/fitness/problems/head_injury.html - head injuries
  
• http://www.emedicinehealth.com/head_injury/article_em.htm - head injury
  

questions:

1. is this a case of child maltreatment? provide evidence to support your decison.

• http://kidshealth.org/parent/medical/brain/shaken.html - abusive head trauma
  
• http://www.emedicinehealth.com/child_abuse/article_em.htm - child abuse
  

2.how might you,as a nurse, be involved in this situation? desribe.

you would need to know your state laws and duty to report suspected child abuse. most states have a law that requires nurses working in ers to report suspected child abuse and they must report.

3. what interventions would you, as the nurse, do in this situation? why?

• treat the child.
  
• notify the physician of your suspicions.
  
• report and follow the law.
  

[toylover]

I appreciate all of your help and especially thank you to Daytonite for giving me useful sites and other information.:redpinkhe:redpinkhe Since I have been in the United States for three years, I don't know much ideas about reporting child abuse following the law. Thank you.:wink2: