A home health nurse suspects physical abuse while assessing a 5-year-old client who recently sustained a spiral femur fracture. The caregiver's explanation of how the injury occurred is inconsistent with the child's developmental abilities and changes multiple times during the visit. Which actions should the nurse take? Select all that apply.
- Document the caregiver's explanations of the injury using direct quotes in the medical record.Answer
- Report the suspected abuse to the designated state child welfare agency immediately.Answer
- Assess the child for additional physical indicators, such as fading bruises or patterned marks.Answer
- DConfront the caregiver directly and demand to know why the explanation of the injury keeps changing.
- EDelay filing an official report until conclusive proof of abuse is found to avoid falsely accusing the family.
- FDelegate the full skin and wound assessment to the unlicensed assistive personnel (UAP) while continuing to interview the caregiver.
Answer
The nurse should document the caregiver's statements using direct quotes, report the suspicion to the child welfare agency immediately, and assess the child for additional physical indicators of abuse.
Appropriate actions for suspected abuse include ensuring objective and accurate documentation of the caregiver's changing story (using direct quotes), conducting a comprehensive assessment for other injuries, and fulfilling the legal obligation to report the suspicion immediately. The nurse's role is to assess, document, and report, not to investigate.
Step-by-Step Solution
Key Concept
In cases of suspected child abuse, the nurse must ensure immediate safety, document objectively using direct quotes, and fulfill mandatory reporting obligations based on reasonable suspicion without attempting to investigate or confront the perpetrator.