Abuse and Neglect for Certified Emergency Nursing (CEN)
Included In This Lesson
Study Tools For Abuse and Neglect for Certified Emergency Nursing (CEN)
Outline
Abuse and Neglect
Definition/Etiology:
- Abuse – most common in elderly and children due to inability for independent care. Physical, sexual, or psychological abuse most common.
- Neglect = Think NEED injury. The breach of duty that occurs in the negligent act must be the proximate cause of the injury in the case of healthcare neglect.
In caregiver neglect, it simply means to pay little or no attention. - Battery – harmful or offensive touching of one person by another.
(example – nurses can be accused of this by giving a patient a medication against their will)
Pathophysiology:
Abuse may occur in various ways and are often experienced by those with a caregiver:
- Withholding of food
- Limiting financial freedom
- Physical harm
- Controlling and limiting of social circle
- Inappropriate managing or medication or withholding medication
Clinical Presentation:
Abuse:
- Physical abuse –
- Bruising in various stages of healing
- Bruises in infants less than 6 months
- Retinal hemorrhages
- Burns (cigarette common, evidence of scalding)
- Frequent fractures
- Sexual abuse –
- Genital bleeding/bruising
- Inappropriate sexual behavior for age
- Caregiver answers for the patient and won’t leave the patient during examination, even during more private portions of the examination
- Neglect –
- Malnutrition
- Developmental delays due to lack of interaction
- Poor hygiene
Collaborative Management:
- R/o any underlying injury from possible trauma
- CT scan for possible underlying brain injury (especially in petechial hemorrhaging)
- Labs, EKG, fluid replacement may be needed in the cases of malnutrition
- Pharmacological interventions may include pain management of correction of electrolyte imbalances.
- Non-pharm interventions include involvement of social work and mandated reporting
- May need to collaborate with social services per department’s protocol
Evaluation | Patient Monitoring | Education:
- Is this person safe to discharge back to their home environment?
- Do we need law enforcement involvement?
- Have we reported appropriately according to our organization/state’s laws and regulations?
- Follow up and possible rehab
- Discharge with any available resources including abuse or neglect hotlines
Linchpins: (Key Points)
- Various types of abuse – think physical bodily harm. Abuse to the body.
- Neglect – failure to act which resulted in harm. Neglected to pay appropriate attention to.
- Bruises in various stages of healing is a key finding
- Suspect closed head injury with any petechial hemorrhage
- Suspect sexual abuse with a caregiver that is extremely smothering and does not allow the patient to speak or leave
Transcript
For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/
References:
- Adigun, O. O., Mikhail, A. G., Krawiec, C., & Hatcher, J. D. (2021). Abuse and Neglect. In StatPearls [Internet]. StatPearls Publishing.
- Dictionary.com. (n.d.). Neglect definition & meaning. Dictionary.com. Retrieved October 12, 2022, from https://www.dictionary.com/browse/neglect
- Liu, J., Kou, Z., & Tian, Y. (2014). Diffuse axonal injury after traumatic cerebral microbleeds: an evaluation of imaging techniques. Neural regeneration research, 9(12), 1222.
NCLEX
Concepts Covered:
- Circulatory System
- Emergency Care of the Cardiac Patient
- Cardiac Disorders
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Upper GI Disorders
- Liver & Gallbladder Disorders
- Newborn Complications
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Test Taking Strategies
- Note Taking
- Basics of NCLEX
- Prefixes
- Suffixes
- Medication Administration
- Gastrointestinal Disorders
- Respiratory Disorders
- Pregnancy Risks
- Labor Complications
- Hematologic Disorders
- Fundamentals of Emergency Nursing
- Factors Influencing Community Health
- Delegation
- Perioperative Nursing Roles
- EENT Disorders
- Basics of Chemistry
- Adult
- Emergency Care of the Neurological Patient
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Documentation and Communication
- Preoperative Nursing
- Endocrine System
- Legal and Ethical Issues
- Communication
- Understanding Society
- Immunological Disorders
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Fetal Development
- Terminology
- Anxiety Disorders
- Cognitive Disorders
- Musculoskeletal Trauma
- Intraoperative Nursing
- Tissues and Glands
- Vascular Disorders
- Renal Disorders
- Eating Disorders
- Prenatal Concepts
- Microbiology
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Depressive Disorders
- Personality Disorders
- Psychotic Disorders
- Trauma-Stress Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Neurologic and Cognitive Disorders
- Integumentary Disorders
- Newborn Care
- Basics of Mathematics
- Statistics
- Labor and Delivery
- Proteins
- Emergency Care of the Trauma Patient
- Hematologic System
- Hematologic Disorders
- Developmental Considerations
- Skeletal System
- Digestive System
- Urinary Disorders
- Postpartum Care
- Basic
- Musculoskeletal Disorders
- Bipolar Disorders
- Metabolism
- Cardiovascular Disorders
- Concepts of Population Health
- Musculoskeletal Disorders
- EENT Disorders
- Postpartum Complications
- Basics of Human Biology
- Postoperative Nursing
- Neurological Emergencies
- Prioritization
- Disorders of Thermoregulation
- Writing
- Community Health Overview
- Dosage Calculations
- Neurological Trauma
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Concepts of Pharmacology
- Integumentary Important Points
- Emotions and Motivation
- Renal and Urinary Disorders
- Developmental Theories
- Reproductive System
- Adulthood Growth and Development
- Psychological Emergencies
- Growth & Development
- Basics of Sociology
- Somatoform Disorders
- Reading
- Intelligence and Language
- Oncologic Disorders
- Med Term Basic
- Med Term Whole
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Learning Pharmacology
- Pediatric
- Psychological Disorders
- State of Consciousness
- Sensory System