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CASE STUDY
Three-year-old female, Tia, dressed in a wool coat and cap is carried into the emergency department of VGH by her mother, Sarah, and accompanied by her boyfriend, Ken. Sarah is a single mom and works full-time nights at a pub in Vancouver. During these hours her boyfriend, Ken, takes care of Tia. Upon admission, Sarah states that Tia would not stop crying and she was not sure about what had happened to the child. Ken interrupts and explains that he saw her fall down the stairs and he ignored the fall because he figured that all three-year-olds fall and he thought nothing of it. Tia was admitted and upon the nurses examination she noted that Tia was guarding her right leg and grimacing and crying in pain. The doctor and the nurse discuss their assessments and immediately the doctor orders an X-Ray for Tia, which is following routine procedures. The nurse reads the child's history in the previous emergency charts and notes that there has been a history of fractures. The nurse comes to the conclusion that there may be two options In relation to this case. First, this condition may be pathophysiological (osteogenesis imperfecta-brittle bones), or second, there may be a suspicion of child abuse. The doctor and the nurse examine and review the X-Rays and take note of multiple old fractures that had not been reported. At this point the doctor decides to run other tests to rule out osteogenesis imperfecta. Tia was then transferred and admitted to 3C at BC Children's Hospital. During this process, the nurse on 3C, Lillian, was caring for Tia and she was aware of the details of this case. Even though there was a suspicion of child abuse, Sarah and Ken were allowed to visit Tia without supervision. The tests for ruling out osteogenesis imperfecta had returned and they were negative.
WHAT NOW?
[Child Abuse]
[Legal Issues]
[Reporting]
[Case Study]
[Nursing Care]
[Self Awareness]
[Main]
Designed by Sherrine Singh & Janene Otto, Collaborative Nursing Program 2003
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