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( can these notes/terms be written so its in complete sentences where a group of high school students can understand them) Infant & Child Safety 1. Child Maltreatment Child maltreatment = neglect or abuse (physical, emotional, or sexual) of a child, usually by a trusted adult. Warning signs of maltreatment include: Unexplained injuries (burns, spiral fractures) and bruises in various stages of healing Injuries not consistent with the child’s age or reported history (fracture from infant jumping off chair) ⮹ Neglect: Poor hygiene, growth failure ⮹ See the AGGRESSION, ABUSE, & ASSAULT CHEAT SHEET for more signs of maltreatment. Nursing interventions ⮹ #1 priority = identifying and reporting abuse as early as possible to prevent further maltreatment. Nurses are mandatory reporters: Immediately report suspected child maltreatment to protective agencies (Child Protective Services, Child Welfare Services). ⮹ Do not promise to keep the child’s secrets. ⮹ Document physical findings and statements objectively (measure bruises, use direct quotations, photograph injuries with consent). ⮹ Prevent abusive head trauma (shaken baby syndrome). ⮹ î ‰risk from inconsolable crying (colic) ⮹ Teach caregivers not to shake the infant; tell them it is okay to take a break by temporarily placing the crying infant in a safe place. î Œ Reporting abuse: Unexplained injuries (spiral fractures) and bruises in various stages of healing are key warning signs of maltreatment. Nurses must immediately report suspected child maltreatment to protective agencies. 2. Sudden Infant Death Syndrome (SIDS) Sudden infant death syndrome (SIDS) = unexpected death of an infant <1 year old, typically during sleep. Teach caregivers strategies to prevent SIDS. Practice the ABCs of safe sleep (TABLE 1). ⮹ Maintain a smoke-free environment. ⮹ Promote protective factors: Breastfeeding, pacifier use, and scheduled immunizations. TABLE 1. THE ABCS OF SAFE SLEEP Alone No cosleeping with the infant. Back Place infant on back to sleep (supine). Crib Use a firm mattress with nothing in the crib (no blankets, pillows, stuffed animals, bumper pads). 3. Car Seat Safety Teach proper use of car seats to prevent injury (FIGURE 1). Place in the back seat (airbags in front seatî ‰risk for injury). Place rear-facing for at least 1 year and continue until the child outgrows the manufacturer's height and weight limits. ⮹ Ensure harness straps are snug, not loose, with Child Health chest clip at armpit level. ⮹ Avoid dressing child in bulky clothing when seated in the car seat; this can loosen the harness. ⮹ Do not use car seats that are expired, damaged, or have been in an accident. î  SIDS prevention: Teach caregivers the ABCs of safe sleep: Infants should sleep Alone, on their Back, and in a Crib with a firm mattress and nothing in the crib (no blankets, stuffed animals, or bumper pads). î Ž Car seat safety: Put the car seat in the back seat. Place it rear-facing for at least 1 year and continue until the child outgrows the manufacturer's height or weight limits. © Bootcamp.com 3 3. Car Seat Safety, Continued FIGURE 1. PROPER CAR SEAT USE 4. Home Safety Young children's curiosity about their surroundings can lead to unsafe behavior thatî ‰risk for injury or death. Prevent injury at home. Drowning: Supervise children near all water (buckets, toilets, bathtubs, pools). ⮹ Falls: Use childproof gates near stairs and ensure child wears protective equipment during activities (helmets). ⮹ Firearm injury: Store guns unloaded in a locked safe, separate from ammunition. Burns ⮹ Cover electrical outlets. ⮹ Turn pot handles toward back of stove. ⮹ Do not use the microwave to heat breast milk or formula. ⮹ Poisoning Keep toxic substances (medications, cleaning products) locked up and out of reach. ⮹ Do not refer to medicine as "candy." If poisoning is suspected, call poison control and seek treatment immediately. ⮹ See the SAFETY CHEAT SHEET for additional information. î  Home safety: To prevent drowning and burns, supervise children near all water (buckets, bathtubs), cover electrical outlets, and do not use the microwave to heat breast milk or formula. 5. Foreign Body Aspiration Prevent and identify foreign body aspiration (FBA). ⮹ Cut up large round foods into small pieces (grapes, hot dogs, nuts). ⮹ Do not allow children to play with coins, small toys, or batteries. ⮹ Signs of aspiration: Sudden, vigorous coughing, gagging, and asymmetrical breath sounds Nursing interventions If child is choking (cannot speak, cyanotic), immediately provide first aid. ⮹ Back blows and chest thrusts for infants (<1 year old) ⮹ Abdominal thrusts (Heimlich maneuver) ≥1 year ⮹ Do not perform blind finger sweeps, which can push objects farther down. 6. Lead Poisoning Lead poisoning occurs when lead is inhaled or ingested from sources such as chipped lead paint (in homes built before or during the 1970s) or contaminated water, dust, and soil. ⮹ Can cause anemia, cognitive delays, and behavioral changes (impulsivity, hyperactivity) Nursing interventions Toî €blood lead levels (BLL), encourage frequent handwashing and wet-mopping toî €exposure. ⮹ Screen children in high-risk environments for elevated BLLs (areas with soil contamination, lead plumbing, or older homes). ⮹ Anticipate chelation therapy to remove lead from the blood. Child Health î  Poisoning prevention: Teach caregivers to keep toxic substances, like medications and cleaning products, locked up and out of reach. If poisoning is suspected, call poison control and seek treatment immediately.

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