can occur in the infant, toddler, preschool, and school-age years. The highest rates of fatal child abuse are found among children aged 0 to 4 years where the most common cause of death is head injury, followed by abdominal injuries and intentional suffocation. The types of abuse among children in this age range include; -Physical abuse. -Sexual abuse. -Emotional abuse. -Neglect.Warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse include; -The battered child- this term is generally applied to children showing repeated and devastating injury to the skin, skeletal system or nervous system. It includes children with multiple fractures of different ages, head trauma and severe visceral trauma with evidence of repeated infliction. However, despite the fact that this cases are tragic, this pattern is rare. -Sexual abuse- children who are brought to seek healthcare may show signs of sexual abuse because of physical and behavioral concerns. However, it is not uncommon for children who have been sexually abused to exhibit symptoms of infection, genital injury, abdominal pain, constipation, chronic or recurrent urinary tract infections or behavioral symptoms. -The shaken infant- shaking is a prevalent form of abuse seen in young children where the majority of shaken children are less 9 months old. Most perpetrators of such abuse are male, though this may be a reflection of the fact that they are more prone than women to shake children. Intracranial haemorrhages, retinal haemorrhages and small ”chip” fractures at the major joints of the child’s extremities can result from very rapid shaking of an infant and they follow from a combination of shaking and the head hitting a surface. -Neglect- many manifestations of child neglect are evident and include non- compliance with the health care recommendations, failure to seek appropriate healthcare, deprivation of food resulting in hunger and the failure of a child physically to thrive. Other causes of concern include the exposure of children to drugs and inadequate protection from environmental dangers.Cultural variations of health practices that can be misidentified as child abuse include; -Coining or caogio which is an ancient healing practice and still being practiced today is a form of dermabrasion therapy, which involves intense rubbing of the skin, is used by Vietnamese, Cambodians, and Laotians to treat a variety of illnesses.  According to this healing practice, there are three major causative categories of illness: physical, metaphysical, and supernatural. Maintaining harmony with nature is a central tenet. Conditions that cause disease include excessive emotions, incorrect diet, or imbalance between hot and cold energies and bad wind.  According to some, the wind can invade the body and cause a variety of illnesses including headaches, muscle aches, coughs, fevers, upper respiratory infections and sore throats . To alleviate the symptoms of these illnesses, the forces are balanced by using herbal remedies and dermabrasion. Ointment oil is applied to the skin and intensive rubbing takes place. -Spooning (guasha) is used in china  to rid the body of illness. This procedure results in a linear pattern of ecchymosis on the patient’s skin when a spoon or spoon-like tool, made of porcelain, jade, bone, horn or similar material, is used to rub the wet skin. Skin eruptions may be generated that resemble a pine tree pattern, with long vertical marks along the spine and paralleling the ribcage as may also be seen in caogio. -Cupping is another ancient,  though fairly common practice, which has been used throughout the Middle East, Asia, Latin America, and Eastern Europe. In the United States, this technique is practiced primarily by Russian immigrants and its use has been revitalized among naturalistic health providers, as well [3,9,11]. There are two types of cupping: wet and dry. Wet cupping, also known as hijama, involves small cuts to the skin to draw blood and is thought to help rid the body of toxins. In dry cupping the air, in an open-mouthed vessel, is heated and subsequently, the vessel is applied to the skin. Suction is produced by the cooling and contracting of the heated air and is thought to “draw out” the ailment as the heated air and the rim of the cup burn the skin. -Moxibustion is a healing practice that involves burning rolled pieces of the moxa herb (mugwort or artemisia vulgaris) directly over the skin above  acupuncture points and allowing the herb to burn near the skin’s surface until the onset of pain. The lesions of moxibustion appear as a pattern of “discrete circular, target-like burns” that may be confused with cigarette burns from child abuse. Moxibustion is one of the most commonly used treatments in traditional medicine.The reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.In Michigan state, anyone who suspects child abuse or neglect can make a report by calling 855-444-3911. In addition the child protection law requires certain professionals to report suspected child abuse or neglect. The process involves the following steps and responsibilities where reports of suspected child abuse or neglect will either be; -Assigned for investigation; -Rejected; or -Transferred to another agency for investigation, such as law enforcement or the Bureau of Child and Adult Licensing.Reports must meet the following three criteria to be assigned for investigation: -The alleged victim is under 18 years of age. -The alleged perpetrator is a parent, legal guardian or other person responsible for the child’s health and welfare. -The allegations minimally meet the child abuse and neglect definitions in the Child Protection Law.Being on the front lines of healthcare, nurses have unfortunately needed to report cases of abuse and neglect as mandated and are trained to identify signs and symptoms of abuse or neglect. If a nurse suspects abuse or neglect, they should first report it to a  physician, nurse practitioner, or physician assistant. Notifying a supervisor may also be required, depending on the workplace. If the victim is with a suspected abuser, the exam should take place without that person in the room. Also nurses should have and provide a calm and comforting environment and should approach the patient with care and concern.  A complete head-to-toe examination should take place, looking for physical signs of abuse. A chaperone or witness should be present if possible as well. Thorough documentation and description of exam findings, as well as patient statements, non-verbal behavior, and behavior/statements of the suspected abuser should also be included.Step-by-step explanationReferences.Clemmons, J. C., Walsh, K., DiLillo, D., & Messman-Moore, T. L. (2007). Unique and combined contributions of multiple child abuse types and abuse severity to adult trauma symptomatology. Child maltreatment, 12(2), 172-181. Killion CM (2017) Cultural Healing Practice

Question Answered step-by-step hild abuse and maltreatment is not limited to a particular age—itcan occur in the infant, toddler, preschool, and school-age years. The highest rates of fatal child abuse are found among children aged 0 to 4 years where the most common cause of death is head injury, followed by abdominal injuries and intentional suffocation. The types of abuse among children in this age range include; -Physical abuse. -Sexual abuse. -Emotional abuse. -Neglect.Warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse include; -The battered child- this term is generally applied to children showing repeated and devastating injury to the skin, skeletal system or nervous system. It includes children with multiple fractures of different ages, head trauma and severe visceral trauma with evidence of repeated infliction. However, despite the fact that this cases are tragic, this pattern is rare. -Sexual abuse- children who are brought to seek healthcare may show signs of sexual abuse because of physical and behavioral concerns. However, it is not uncommon for children who have been sexually abused to exhibit symptoms of infection, genital injury, abdominal pain, constipation, chronic or recurrent urinary tract infections or behavioral symptoms. -The shaken infant- shaking is a prevalent form of abuse seen in young children where the majority of shaken children are less 9 months old. Most perpetrators of such abuse are male, though this may be a reflection of the fact that they are more prone than women to shake children. Intracranial haemorrhages, retinal haemorrhages and small ”chip” fractures at the major joints of the child’s extremities can result from very rapid shaking of an infant and they follow from a combination of shaking and the head hitting a surface. -Neglect- many manifestations of child neglect are evident and include non- compliance with the health care recommendations, failure to seek appropriate healthcare, deprivation of food resulting in hunger and the failure of a child physically to thrive. Other causes of concern include the exposure of children to drugs and inadequate protection from environmental dangers.Cultural variations of health practices that can be misidentified as child abuse include; -Coining or caogio which is an ancient healing practice and still being practiced today is a form of dermabrasion therapy, which involves intense rubbing of the skin, is used by Vietnamese, Cambodians, and Laotians to treat a variety of illnesses.  According to this healing practice, there are three major causative categories of illness: physical, metaphysical, and supernatural. Maintaining harmony with nature is a central tenet. Conditions that cause disease include excessive emotions, incorrect diet, or imbalance between hot and cold energies and bad wind.  According to some, the wind can invade the body and cause a variety of illnesses including headaches, muscle aches, coughs, fevers, upper respiratory infections and sore throats . To alleviate the symptoms of these illnesses, the forces are balanced by using herbal remedies and dermabrasion. Ointment oil is applied to the skin and intensive rubbing takes place. -Spooning (guasha) is used in china  to rid the body of illness. This procedure results in a linear pattern of ecchymosis on the patient’s skin when a spoon or spoon-like tool, made of porcelain, jade, bone, horn or similar material, is used to rub the wet skin. Skin eruptions may be generated that resemble a pine tree pattern, with long vertical marks along the spine and paralleling the ribcage as may also be seen in caogio. -Cupping is another ancient,  though fairly common practice, which has been used throughout the Middle East, Asia, Latin America, and Eastern Europe. In the United States, this technique is practiced primarily by Russian immigrants and its use has been revitalized among naturalistic health providers, as well [3,9,11]. There are two types of cupping: wet and dry. Wet cupping, also known as hijama, involves small cuts to the skin to draw blood and is thought to help rid the body of toxins. In dry cupping the air, in an open-mouthed vessel, is heated and subsequently, the vessel is applied to the skin. Suction is produced by the cooling and contracting of the heated air and is thought to “draw out” the ailment as the heated air and the rim of the cup burn the skin. -Moxibustion is a healing practice that involves burning rolled pieces of the moxa herb (mugwort or artemisia vulgaris) directly over the skin above  acupuncture points and allowing the herb to burn near the skin’s surface until the onset of pain. The lesions of moxibustion appear as a pattern of “discrete circular, target-like burns” that may be confused with cigarette burns from child abuse. Moxibustion is one of the most commonly used treatments in traditional medicine.The reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse.In Michigan state, anyone who suspects child abuse or neglect can make a report by calling 855-444-3911. In addition the child protection law requires certain professionals to report suspected child abuse or neglect. The process involves the following steps and responsibilities where reports of suspected child abuse or neglect will either be; -Assigned for investigation; -Rejected; or -Transferred to another agency for investigation, such as law enforcement or the Bureau of Child and Adult Licensing.Reports must meet the following three criteria to be assigned for investigation: -The alleged victim is under 18 years of age. -The alleged perpetrator is a parent, legal guardian or other person responsible for the child’s health and welfare. -The allegations minimally meet the child abuse and neglect definitions in the Child Protection Law.Being on the front lines of healthcare, nurses have unfortunately needed to report cases of abuse and neglect as mandated and are trained to identify signs and symptoms of abuse or neglect. If a nurse suspects abuse or neglect, they should first report it to a  physician, nurse practitioner, or physician assistant. Notifying a supervisor may also be required, depending on the workplace. If the victim is with a suspected abuser, the exam should take place without that person in the room. Also nurses should have and provide a calm and comforting environment and should approach the patient with care and concern.  A complete head-to-toe examination should take place, looking for physical signs of abuse. A chaperone or witness should be present if possible as well. Thorough documentation and description of exam findings, as well as patient statements, non-verbal behavior, and behavior/statements of the suspected abuser should also be included.Step-by-step explanationReferences.Clemmons, J. C., Walsh, K., DiLillo, D., & Messman-Moore, T. L. (2007). Unique and combined contributions of multiple child abuse types and abuse severity to adult trauma symptomatology. Child maltreatment, 12(2), 172-181. Killion CM (2017) Cultural Healing Practice Health Science Science Nursing NRS- 434V Share QuestionEmailCopy link Comments (0)

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