Which is the priority nursing action when working with a parent who is suspected of Munchausen syndrome by proxy?
1. Try to keep the parent separated from the child as much as possible.
2. Explain to the child that the parent is causing the illness and that the healthcare team will prevent the child from being harmed.
3. Carefully document parent–child interactions.
4. Confront the parent with concerns of possible abuse.
3
Explanation:
1. Separating the parent from the child might alienate the parent and cause her to leave with the child.
2. Talking to the child about the healthcare team's suspicions could be confusing and frightening for the child.
3. 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.
4. Confronting the parent might alienate the parent and cause her to leave with the child.
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