In caring for a 4-year-old child with a diagnosis of suspected child abuse, which is the best nursing intervention?
a. Avoid touching the child.
b. Provide the child with play situations that allow for disclosure.
c. Discourage the child from remembering the incident.
d. Deny the suspected perpetrator visiting rights to the child.
B
Play allows the child to disclose what happened to him or her without having to talk about the incident. Symbolic play is important for emotional development and it allows the child to work through distressing feelings. All children need to be touched. What is important is to tell the child in simple, clear terms what you are doing and why you are doing it. Nurses have the opportunity to teach children the normal, healthy boundaries of their bodies and what constitutes inappropriate behavior. If the child chooses to remember what happened, it is inappropriate to discourage it. It is important to listen to the child in a nonjudgmental way, allowing the child to discuss what happened, to make statements, or to ask questions. It is not the nurse's role or responsibility to restrict visitors unless child safety is an issue. The child may be negatively affected if a caregiver, who may be the abuser, does not visit.
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The nurse in the Emergency Department is taking a history from a family accompanying a child with suspicious traumatic injuries. The nurse should:
1. Obtain information as covertly as possible 2. Avoid responding to hints that abuse has occurred 3. Be open, concerned, and honest 4. Separate the family from the child during the interview