Critical Thinking Exercise 53.1
Matthew, aged 2 years, is brought to the emergency department by his mother, Ms. Jackson, and her boyfriend. Ms. Jackson tells the nurse that Matthew has been crying and holding his arm since she picked him up at the babysitter’s earlier in the evening. On further questioning, Ms. Jackson states “Matthew is all boy. You have to watch him every minute or he is into something. He is constantly climbing and falling.”
On examination, the nurse notes several bruises on Matthew’s right leg and right arm. He also has a small abrasion on his nose. Ms. Jackson is holding Matthew and seems concerned, as does her boyfriend. Matthew quiets when his mother holds him, and he drifts off to sleep. Ms. Jackson’s boyfriend leaves the room and returns with a snack for both Matthew and Ms. Jackson. He offers to hold Matthew.
1. What are some of the possible reasons Matthew is crying and holding his arm? Support your assumptions with rationales.
2. If the nurse suspects child abuse, what added assessments should be performed?
3. What legal responsibility does the nurse have in cases of suspected child abuse?
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