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Difficulty: MediumAbuse or Neglect

A practical nurse (PN) is providing care for a 5-year-old client in a pediatric ambulatory clinic. During the physical data collection, the PN notes distinct, linear marks on the child's upper back. The accompanying parent gives a vague and contradictory explanation for how the marks occurred. Which actions should the PN take? (Select all that apply).

  1. Document the exact size, shape, color, and location of the marks using objective language.Answer
  2. Notify the supervising registered nurse (RN) and the healthcare provider about the findings immediately.Answer
  3. Follow facility protocol to ensure a report is filed with the appropriate child protective services agency.Answer
  4. D
    Wait to notify authorities until there is concrete evidence that the parent intentionally caused the injuries.
  5. E
    Confront the parent about the inconsistencies in their story to determine the truth.
  6. F
    Promise the child that anything they disclose about the injuries will be kept strictly secret.

Answer

The correct actions are to document the objective findings precisely, notify the supervising RN and healthcare provider, and ensure a mandated report is made to child protective services.
When abuse is suspected due to unexplained or inconsistently explained physical injuries, the practical nurse's primary responsibility is client safety and mandated reporting. Documenting the findings objectively provides a vital and accurate legal record. Notifying the supervising RN and healthcare provider ensures the team can medically evaluate the child and collaborate on safe discharge planning. Finally, as mandated reporters, nurses must ensure that suspicions are formally reported to child protective services according to local laws and facility protocols.

Step-by-Step Solution

1
Identify the client's risk based on the physical findings and history.
Linear marks and a contradictory history from the parent strongly suggest non-accidental trauma (abuse).
Recognizing the classic indicators of abuse is the necessary first step in ensuring client safety.
2
Determine the PN's legal and ethical responsibilities.
The PN must report the findings to the healthcare team and ensure protective services are officially notified.
Practical nurses act as mandated reporters of suspected child abuse under state laws.
3
Select the appropriate, safe nursing interventions.
Objective documentation, team notification, and official reporting are prioritized over confronting parents or keeping secrets.
These actions maintain the child's immediate safety and fulfill legal requirements without interfering with future investigations.

Key Concept

Mandated Reporting of Suspected Child Abuse
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Topics

Abuse or Neglect

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