4 Child Abuse Nursing Care Plans

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The term child abuse is used to describe any neglect or mistreatment of infants or children including infliction of emotional pain, physical injury, or sexual exploitation. Neglect or abuse is most often inflicted by the child’s biological parents. Others who have been implicated include foster parents, babysitters, boyfriends, friends, and daycare workers. Nurses are legally and morally responsible to identify children who may be maltreated and to report findings to protect the child from further abuse.

Neglect is the most common form of abuse and may include deprivation of basic physical or emotional needs: food, clothing, shelter, healthcare, education, affection, love, and nurturing. Emotional abuse stems from rejection, isolation, and/or terrorizing the child.

Physical abuse may result in burns, bruises, fractures, lacerations, or poisoning. Infants may suffer from “shaken baby syndrome” with severe or fatal neurologic injuries caused
by violent shaking of the infant. Signs of shaken baby syndrome include retinal and subarachnoid hemorrhage. Signs of sexual abuse include bruising or bleeding of the anus or genitals, genital discharge, odor, severe itching or pain, and sexually transmitted diseases. A discrepancy between the nature of the child’s injuries and the reported cause of injury is a frequent clue that abuse has occurred.

Nursing Care Plans

The major nursing care planning goals for the child experiencing abuse includes ensuring adequate nutrition, safety of the abused child, relief from anxiety, improving parenting skills and building parental confidence.

Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for child abuse:

  1. Imbalanced Nutrition: Less Than Body Requirements
  2. Anxiety
  3. Impaired Parenting
  4. Risk for Trauma
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Impaired Parenting

Impaired Parenting: Inability of the primary caregiver to create, maintain, or regain an environment that promotes the optimum growth and development of the child.

May be related to

  • Unmet social and emotional maturation needs of parental figures
  • Ineffective role modeling
  • Lack of knowledge
  • Situational crisis or incident

Possibly evidenced by

  • Lack of parental attachment behaviors
  • Verbalization of resentment toward the child and of role inadequacy
  • Inattention to needs of the child
  • Noncompliance with health practices and medical care
  • Inappropriate discipline practices
  • Frequent accidents and illness of child
  • Growth and development lag in child
  • History of child abuse or abandonment
  • Multiple caretakers without regard for needs of child
  • Evidence of physical and psychological trauma, actual abandonment of child

Desired Outcomes

  • Parent will demonstrate appropriate parenting behaviors.
  • Parent will provide a safe environment for child.
  • Parent will establish positive relationship with child and realistic expectations for self and child.
Nursing InterventionsRationale
Assess parents for the achievement of  developmental tasks of self and
understanding of child’s growth and
development; how they are bonded and
attached to the child; how they interpret
and respond to the child; how they accept
and support child; how they meet child’s social, psychological and physical needs.
Provides information about parent-child relationship and parenting styles that may lead to child abuse; identifies parents at risk for violence or other abusive behavior.
Provide an opportunity for parents to express their feelings, personal needs, and goals; avoid making judgmental remarks or comparing them to other parents.Supports parents in meeting their own needs.
Praise parents for their participation in child’s care, tell them that they are giving good care to the child.Reinforces positive parenting behaviors and increases a feeling of adequacy.
Provide a child nurturing role model for parents to emulate.Promotes the development of parenting skills by imitation.
Include parents in planning care and setting goals.Promotes participation of parents in meeting child’s needs.
Discuss with parents methods to reduce conflict, to be consistent in approach to child’s behavior and needs, to avoid siding with the child or other parents.Promotes a more positive child-parent relationship.
Teach parents developmental tasks for
child and parents, difference in developmental level between child and parents, and appropriate tasks for age levels.
Provides information that assists parents in responding realistically and appropriately to child’s needs at different age levels.
Instruct parents to maintain their own health by getting adequate rest, nutrition, and exercise; and to participate in leisure activities and make social contacts.Provides information on the importance of parents meeting their own needs to enable them to better care for and cope with their children.
Refer to community agencies that offer
parenting classes and support groups.
Provides education in parenting skills.
Initiate referrals to social services,
parenting classes, or counseling as
appropriate. Inform parents that child protection services have been contacted to investigate the child’s health status and safety; keep the parents informed of the child’s health status (unless or until
custody of the child is removed from
the parents.
Provides options if parenting is unsatisfactory or inadequate.
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See Also

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Pediatric Nursing Care Plans


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