A nurse is assessing a child who is suspected of being physically abused by his father. Which of the following findings should the nurse report as possible indicators of abuse? (Select all that apply.)
A. The child has bruises on his knees and elbows.
B. The child has a spiral fracture of his left femur.
C. The child has a burn mark on his chest in the shape of a cigarette.
D. The child has a subdural hematoma with no history of head trauma.
E. The child has a bite mark on his shoulder that matches his own dental impression.
The correct answer and Explanation is :
In assessing a child suspected of being physically abused, the following findings should be reported as possible indicators of abuse:
B. The child has a spiral fracture of his left femur.
C. The child has a burn mark on his chest in the shape of a cigarette.
D. The child has a subdural hematoma with no history of head trauma.
Explanation:
When evaluating potential child abuse, nurses should be aware of specific physical indicators that raise concern.
Spiral fractures (option B) are commonly associated with abuse, particularly in young children. Such fractures typically occur from twisting or rotational forces, which can happen in abusive situations but are less likely to occur from normal play or accidental falls.
Burns (option C) that have distinct patterns, such as cigarette burns, are also strong indicators of abuse. These injuries are often intentional and suggest a deliberate act of harm, as opposed to accidental burns that might result from common household accidents.
Subdural hematomas (option D) without a history of head trauma are particularly concerning. This finding can suggest that the child has experienced significant trauma that was not reported, raising suspicion of non-accidental injury.
In contrast, the presence of bruises on the knees and elbows (option A) can occur from normal play activities and is not in itself indicative of abuse, especially if they are in common areas for childhood injuries. Similarly, a bite mark (option E) that matches the child’s own dental impression may not necessarily indicate abuse if the context surrounding the injury is benign.
Reporting these indicators is critical for ensuring the child’s safety and initiating appropriate protective measures and investigations by child protective services. Early identification and intervention can significantly impact the child’s future well-being and safety.