Question

Complete a CARE PLAN for victims of intimate partner abuse, child abuse, and sexual assault. (Select one) The six steps of the nursing process required

1- assessment

2- diagnosis

3- outcome identification

4- planning

5- implementation

6- evaluation

Answer 1

Overview

Abuse is a non accidental physical injury or the non accidental act of omission of care by a parent or a person responsible for the child.It can be any forms Neglect,Physical abuse,Emotional abuse,Sexual abuse and Shaken baby syndrome.

1.Assessment

A.Physical signs/behaviours or physical\sexual abuse such as patterns of bruises,Burns,Unexplained fractures,Pain or bleeding genitals,Stains,Withdrawn or Aggressive behaviour

B.Signs of Neglect:Hunger,Poor hygiene/Nutrition,fatigue

C.Signs of Emotional abuse:Habitual behaviours like( thumb sucking,rocking,head banging)conduct/learning disorders.

2.Diagnosis

a.Imbalanced Nutrition less than body requirements may be related to parental neglect on nutritional status.

Outcomes-Child will manifest no further weight loss and,if malnourished ,will gain 1kg per week.

b.Anxiety related to situational crisis or threat to self-concept.

Outcomes-Child will make eye contact,has relaxed facial features,reports decreased anxiety if age-appropriate.

c.Impaired Parenting related to ineffective role modelling

Outcomes-Parents will provide a safe environment for child.

d.Risk for injury related to characteristics of child,caregivers,environment.

Outcomes-Child will not experience maltreatment or abuse by parents or other offenders.

3.Planning and implementation

A.Goals

1.Child will be safe until home assessment made by child welfare agency

2 Child will participate with nurse for emotional support.

3Client will be able to contact agencies to deal with own rage/helplessness.

4 Parents will participate in therapy.

B Interventions

1.Provide nursing care specific to physical/emotional symptoms.

2.Conduct interview in private with the child and poarents separated

3.Inform parents of requirement to report suspected abuse.

4 Do not probe for information or try to prove abuse.

5.Be supportive and non-judgemental.

6.Provide referrals for assistance and therapy.

C.Evaluation

1.Physical symptoms have been treated

2.Child safety has been ensured

3.Parents have agreed to seek help.

Answer 2

CHILD ABUSE: refers to any neglect or mistreatment of infants or children which includes emotional pain, physical injury or due to sexual exploitation. ASSESSMENT: Subjective data: The child may experience inability to ingest foods due to emotion and parental neglect on nutritional status. Objective data: The child shows symptoms of malnutrition,weight loss, less intake of food, loss of subcutaneous fat and failure to thrive. NURSING DIAGNOSIS: Imbalanced nutrition less than the body requirements related to less intake of nutrients to meet metabolic needs. OUTCOMES: Child will manifest no further weight loss and if malnourished, the child will gain 2.2lb or 1kg per week. PLANNING: 1. Registered nurse will assess the patient to relieve from emotions. 2. Registered nurse will encourage the child to enhance self-esteem. 3. Registered nurse will help to treat malnutrition. 4.Registered nurse will help the parents to assist in feeding the child. IMPLEMENTATION AND RATIONALE: 1. Assess for signs and symptoms of malnutrition to decrease the attention span of the child. 2. Monitor food intake and output to evaluate the number of calories being consumed. Weight the client daily to know the progress of nutritional therapy. 3. Maintain good oral hygiene prior to meals to enhance the taste of foods and to promote good appetite. 4. Encourage small and frequent feedings to to decrease fatigue by adding more carbohydrate and protien diet. 5. Encourage parents to assist in feeding the child during feeding to improve self-esteem. 6. Encourage the child to take adequate resting periods to relieve from symptoms like fatigue. 7. Consider enteral or parenteral nutritional support if indicated to maintain nutritional itake by oral route. 8.Consider and refer to a dietician to increase the nutritional status of the child. EVALUATION: I feel that in many ways the child and parents understands the teaching,but I also think that the child have emotional challenges and does not have much of a desire to change and would rather simple live each day despite consequences. Iam very curious about the child status to relieve from malnutrition.