The nurse works in a pediatric unit. In working with a parent who is suspected of Munchausen syndrome by proxy, it is very important for the nurse to:
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
2
Rationale:
1. Confronting the parent might alienate the parent and cause her to leave with the child.
2. Munchausen 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.
3. Separating the parent from the child might alienate the parent and cause her to leave with the child.
4. Talking to the child about the health care team's suspicions could be confusing and frightening for the child.
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