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NRS 434 Topic 2 DQ 1:Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse

nrs 434 topic 2 dq 1: describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse

Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age.

NRS 434 Topic 2 DQ 1

Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.


There a scores of resources available to the nurse designed to better identify possible abuse, whether it be physical or emotional. When considering possible signs of abuse or mistreatment, the nurse should recognize acute changes in the child’s behavior or patterns. NRS 434 Topic 2 DQ 1nrs 434 topic 2 dq 1:describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse

According to the Child Welfare Department, a federally funded and mandated agency (Child Welfare Department, 2019), indicators that interventions may be needed are a decline in a child’s school performance.


This may be related to lack of concentration as the child may withdraw as a sign of their own assessment of the degree of safety present in engaging and/or participating in contact with peers or authority figures outside of the home.NRS 434 Topic 2 DQ 1

Excessive absences may be attempts to allow time for healing of results of physical abuse such as abrasions, bruises, or fractures. Reluctantly to go home after school may also be an indicator of possible abuse.

Abuse goes beyond the physical nature. Emotional abuse has just as long lasting effects on school age children as physical abuse does. School age children are at a stage in their life where they desire to fit in with their peers, notice differences between themselves and other children, and may need assurance that abuse is not their fault (Falkner, 2018).


Child Welfare Information Gateway (2019). What is child abuse and neglect. Retrieved from

Falkner, A. (2018). Grand Canyon University (E.D). Age-Appropriate Approach to Pediatric Health Care Assessment. Retrieved from 434 topic 2 dq 1:describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse

You have provided an in-depth post and I agree with you. Ideally, child abuse and maltreatment is associated with devastating effects on children (Gonzalez et al., 2021). As such, it is important to report any case of child abuse.NRS 434 Topic 2 DQ 1,  As mandated, nurses are trained to recognize signs and symptoms of child abuse or maltreatment and report to the relevant authority.

Failure to report may lead to legal actions against them or disciplinary actions by their employers or board of nursing. If a nurse infers abuse or maltreatment, the first step is to report to the physician, nurse managers, or physician assistant.

If the victim is presented to the facility with the alleged perpetrator, the assessment should be done without the perpetrator in the room. A comprehensive head-to-toe examination should be conducted to identify physical signs of abuse. It is essential to have a witness if possible.

Nurses should ensure a comprehensive documentation and description of the findings, non-verbal behaviors, victim statements, and the statements and behaviors of the alleged perpetrator. The law enforcement should be notified instantly while the victim is still in the facility. Moreover, Child Protective Services should be called and followed up with a documented report (Lee & Kim, 2018).


Gonzalez, D., Mirabal, A. B., & McCall, J. D. (2021). Child abuse and neglect. StatPearls [Internet].

Lee, H. M., & Kim, J. S. (2018). Predictors of intention of reporting child abuse among emergency nurses. Journal of pediatric nursing38, e47-e52.

Child abuse is described as the intentional or unintentional damage (sexually, physically, or emotionally) of any child. Deprivation, ill-treatment, and neglect come under the umbrella of child abuse. Unexplained bruises and injuries, changes in behavior or dietary patterns, aggressive nature, or remaining silent are the signs of abuse.

Unfortunately, child abuse is still prevalent across the world, especially in the United States. In 2019, there were approx 650000 documented occurrences of child abuse, with neglect being the most frequent kind of maltreatment in the United States. Child abuse knows no gender discrimination and the rates are almost similar between boys and girls.

NRS 434 Topic 2 DQ 1

There is a positive relationship between official child abuse and environmental poverty in all racial/ethnic groups (Kim & Drake, 2018).

Child abuse among toddlers is very common. They are prone to physical, emotional, and sexual abuse. The signs of physical abuse are children returning home with unexplained injuries, bruises, abrasions, cuts, bite marks, or other physical signs. Repeated injuries of any kind might be a red flag. If there are changes in their typical behavior, such as being very irritable, anxious, furious, or silent, child abuse can be suspected.

The signs of sexual abuse are genital discomfort, bruising in the genital areas, itching, bleeding, frequent urinary tract infections, and trouble walking or sitting due to genital or anal discomfort. Emotional abuse can be identified when the child exhibits signs of behavioral issues or changes, such as avoiding a parent’s attention, becoming excessively angry or despondent. Abused children frequently exhibit extreme behavior.

The nurse by taking a proper history from the child and parents and observing the signs as mentioned above can rule out abuse.NRS 434 Topic 2 DQ 1

Many cultural practices are prevalent in various countries and can be misidentified as abuse. Coining is practiced in South East Asian countries in which the kin that has been greased with oil is scraped with a ceramic spoon, a worn coin (Vitale & Prasad, 2017). Moxibustion is another traditional Chinese therapeutic technique that originated in Asian medicine and included burning rolled pieces of moxa plant (Killon, 2017).

In my state (Florida), various abuse hotlines, toll-free numbers function 24 hours a day with the availability of counselors. The person reporting can contact and submit the details of the abuse. The complainant can register the complaint on also.NRS 434 Topic 2 DQ 1

Killion, C. M. (2017). Cultural healing practices that mimic child abuse.

Kim, H., & Drake, B. (2018). Child maltreatment risk as a function of poverty and race/ethnicity
in the USA. International journal of epidemiology47(3), 780-787.

Vitale, S. A., & Prashad, T. (2017). Cultural awareness: coining and cupping. Int Arch Nurs Health Care3(3), 080.NRS 434 Topic 2 DQ 1

I do agree with you that child abuse is still prevalent in the US with approximately 4.4 million reported cases annually by the American Society for Positive Care of Children annually (Cooley & Taussig, 2021). However, some 3.5 million cases go unreported annually.

Of the 4.4 million cases reported about 3.4 million received prevention and post response services. Socio-economic factors are the key indicators of such cases of child abuse happening. The cases are common in families of lower income and one or both parents abuse drugs (Tarantola, 2018).

NRS 434 Topic 2 DQ 1

Addiction to use of prescription drugs or other hard drugs have been strongly linked to emotional instability and such parents have shown greater possibilities of mistreating their children from early age onwards. The cases of child abuse know no gender as both boys and girls are abused in equal measure. NRS 434 Topic 2 DQ 1

It is in the adolescent stage that the child strongly manifests the symptoms of child abuse (Li et al., 2021). At this age those abused may become extremely aggressive with high emotions that can be self-destructive is not well managed. However, girls are susceptible to forms of abuse related to either sexual exploitation or child sex-trafficking.

From the year 2018, 29 states have reported about 900 unique cases of child sex trafficking. The majority of the victims, about 90 percent were girls.


Cooley, J. L., & Taussig, H. N. (2021). Anger and Attention Problems as Mechanisms Linking Maltreatment Subtypes and Witnessed Violence to Social Functioning Among Children in Out-of-Home Care. Child Maltreatment, 107755952110389.

Li, W., Yang, J., Gao, L., & Wang, X. (2021). Childhood Maltreatment and Adolescents’ Aggression: A Moderated Mediation Model of Callous-Unemotional Traits and Friendship Quality. Child Maltreatment, 107755952110465.

Tarantola, D. (2018). Child Maltreatment: Daunting and Universally Prevalent. American Journal of Public Health108(9), 1119–1120.

Infant and toddler abuse are very prevalent type of abuse that we see in children. Child abuse can include physical, sexual, or psychological abuse, or a combination of any of the three. It is important to access signs and symptoms of abuse in children because they might have effects later. Abuse might occur from home through caregivers or close family members.

Risks associated with abuse of any kind include poverty, mental illness, and alcohol or substance abuse (Ho, Bettencourt & Gross, 2017). Toddlers who ae abused physically will have unexplained bruises, abrasions, burns, cuts, broken bones, black eyes, bite marks and other injuries that cannot be well accounted for

Emotionally this child will be very withdrawn and scared of their caregiver. They will have behavioral problems like acting angry and depressed, they will sometimes act very aggressively and in a demanding manner. Behavioral signs that could be indicative of abuse may include fearfulness, inappropriate sexual behavior, abnormal or irrational fears, and social withdrawal. (Lee, Lindberg, Frasier, & Hymel,2021).

Doing a thorough assessment will help in identifying any abuse suspicions. The victims and caregivers in this case will be very reluctant to provide any information therefore Nurses should be able to make a judgement of their assessments and follow the correct reporting mechanism of suspected child abuse according to their state laws.

Cultures vary differently and what is acceptable in one culture might not be acceptable in another one. Some cultures spank their kids as a form of discipline and it is acceptable to them, other cultures will view that as abuse. Some cultures practice coining as a form of treating many illnesses but this could be mistaken for abuse. (Tan, & Mallika 2011). It is important to be culturally sensitive before making conclusions on about child abuse. It is our ethical duty as nurses to report child abuse, Ohio has a hotline that is confidential for reporting suspected child abuse.


Ho, G. W. K., Bettencourt, A., & Gross, D. A. (2017). Reporting and identifying child physical abuse: How well are we doing? Research in Nursing and Health, 40(6), 519-527. doi:10.1002/nur.21818

Lee, G. S., Lindberg, D. M., Frasier, L. D., & Hymel, K. P. (2021). A changing history: When is it a red flag for child abuse? Child Abuse & Neglect117

TAN AK, & MALLIKA PS. (2011). Coining: An Ancient Treatment Widely Practiced among Asians. Malaysian Family Physician6(2&3), 97–98.

I do agree with you that child abuse cases in the US occurs in many varied forms ranging from physical abuse to psychological one. Preventing child abuse and neglect can be accomplished through a variety of methods (Cirik et al., 2017). Primary care programs designed to identify high-risk patients and refer them to community resources, parent education to improve nurturing and increase the use of positive discipline strategies, and psychotherapy to improve caregivers’ coping skills and strengthen the parent-child relationship are examples of specific interventions (Curry et al., 2018).

These interventions are provided in a variety of settings, including primary care clinics, schools, and the community.

These programs typically entail a professional or paraprofessional (e.g., a peer educator or a community health worker) visiting a family’s home on a regular basis to provide counseling, educational services, or assistance (Molnar et al., 2021). Families are most frequently identified and referred by health care professionals during the prenatal and postpartum periods.

Assessing family needs, giving information and referrals, providing clinical care, and strengthening family functioning and positive child-parent interactions are all part of these services. To assist families with young children, all states and the District of Columbia, as well as tribal and territorial governments, offer home visitation programs (Curry et al., 2018).


Cirik, V., Ciftcioglu, S., Efe, E., Cirik, V., Ciftcioglu, S., & Efe, E. (2017). Preventing child abuse and neglect. Archives of Nursing Practice and Care3(3), 064–067.

Curry, S. J., Krist, A. H., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., Doubeni, C. A., Epling, J. W., Grossman, D. C., Kemper, A. R., Kubik, M., Landefeld, C. S., Mangione, C. M., Silverstein, M., Simon, M. A., Tseng, C.-W., & Wong, J. B. (2018). Interventions to Prevent Child Maltreatment. JAMA320(20), 2122.

Molnar, B. E., Scoglio, A. A. J., & Beardslee, W. R. (2021). Community-Level Prevention of Childhood Maltreatment: Next Steps in a World with COVID-19. International Journal on Child Maltreatment: Research, Policy and Practice3(4), 467–481.

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