The pediatric nurse is working with a parent who is suspected of Münchausen Syndrome by Proxy. Which action by the nurse is the priority?
1. Confront the parent with concerns of possible abuse.
2. Carefully document parent–child interactions.
3. Try to keep the parent separated from the child as much as possible.
4. Explain to the child that the parent is causing the illness and that the health team will prevent the child from being harmed.
Correct Answer: 2
Rationale: Münchausen Syndrome by Proxy is very difficult to prove, and evidence provided by the careful documentation of the nursing staff can be very influential. Care must be taken not to make the parent suspicious and to keep the child in the hospital until enough evidence is collected. Confronting the parent or separating the parent from the child may alienate the parent and cause him or her to leave with the child. Talking to the child about the health-care team's suspicions may be confusing and frightening for the child.
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