A nurse is admitting a 79-year-old woman with a fractured hip to the orthopedic unit. Her husband states that she broke her hip when she tripped in her garden. Upon examination, the nurse notes purple, green, and yellow bruises on the back and arms. The patient states that those were received when she fell. The nurse should do which of the following?
a. Ask the husband to wait in the waiting room.
b. Ignore the bruises because the patient has provided an explanation.
c. Realize that the patient may be abused, but that is a family issue.
d. Prepare to discharge the patient home once treatment is complete.
A
Patients are more likely to reveal problems when the suspected abuser is not present in the room. Psychological abuse as well as obvious physical injury or neglect (e.g., evidence of malnutrition or presence of bruising on the extremities or trunk) should be assessed. If you have suspicion of abuse, find a way to interview the patient privately. If you assess a pattern of findings indicating abuse, most states mandate a report to a social service center. (Refer to state guidelines.) Obtain immediate consultation with a health care provider, social worker, and other support staff to faci-litate placement in a safer environment.
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