Child Albuse & Violence

The Healthy People 2000 objectives of the Surgeon General and the American Nursing Association directed nurses to ôEnd Violence in the United Statesö by reducing homicides and abuse in children (Patterson, 1998, 49). The majority of cases filed by healthcare institutions of child abuse are of physical abuse, but emotional and sexual abuse, neglect, shaken baby syndrome, and fetal alcohol syndrome are also child abuse.

Physical abuse is defined as injury to a child inflicted by a caretaker, and includes hitting, kicking, shaking, throwing or dropping, pinching, biting, burning, twisting extremities, boxing ears, choking, grabbing, squeezing, pulling hair, poisoning, or the use of weapons (Patterson, 1998, 49). Abuse can occur at any age, but the majority of physically abused children are below age three (66 percent to 78 percent), and of those, as many as 30 percent are under age six months. Presenting injuries include head

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shaking of an infant who is being held by the extremities or shoulders, leading to whiplash-induced intracranial and intraocular bleeding and little or no external signs of head traumaö (Lewis, 2002, 509). The blood vessels and brain tissue are extremely fragile because the infant has very weak neck muscles and a large head. If an infant is vigorously shaken, the brain is jarred with tremendous force, which causes the blood vessels to break and the brain tissue to swell. The hallmark of shaken baby syndrome is retinal hemorrhages. Other signs and symptoms include seizures, subdural hemorrhages, vomiting, lethargy, drowsiness, irritability, respiratory difficulty, and failure to thrive. The syndrome is sometimes difficult to diagnose because the infant is often brought to the emergency room long after the initial injury has occurred, and the symptoms are not conclusive. A diagnosis of shaken baby syndrome is suspected when the injuries do not match the history or when retinal hemorrhages are seen on eye examination. Fetal alcohol syndrome is considered to be part of fetal alcohol spectrum disorders, and was first described in 1973 (Sokol, Delaney-Black and Nordstrom, 2003, 2996). It is diagnosed when ôcharacteristic faci
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Approximate Pages = 10 (250 words per page)