re (Ohio State Medical Association, 1992).Because children who are sexually abused are commonly manipulated into secrecy, nurses must remain alert to the possibility of abuse, even when the child says nothing or says that he/she has never been hurt. When the child gives a history of sexual abuse, the information must be received in a sensitive manner and must be taken seriously. An evaluation is mandatory. If the nurse/physician is unable to provide these services, a referral must be made immediately. Time loss can result in danger to the child or lack of evidence in prosecution of the perpetrator (Ohio State Medical Association, 1992).Behavioral sign and symptoms which may be exhibited in a sexually abused child may include: Extremes of activity, poor self-esteem, poor relationships, express general feelings of shame or guilt, display a distorted self-image, regressive behavior, enuresis, appear frightened of adults, pseudomature behaviors, exhibit a deterioration in academic performance, have an eating disorder, display sexually provocative behavior, sexually abuse a sibling, friend, or younger child, become sexually promiscuous, become pregnant, run away, attempt suicide, specific signs are: rectal or genital pain or bleeding, sexually transmitted diseases in prepubertal children, sexually precocious behavior(Ohio State Medical Association, 1992).If court evidence becomes necessary, well-documented medical records may eliminate or reduce the time a nurse may be required to spend in judicial proceedings. Medical records provide the most concrete and sometimes only evidence of abuse of a child. The records should be kept in a precise, professional manner and should include: A standard, thorough, pediatric health assessment, direct quotations verbatim, statements made by the child and caretaker, observed behavior, the location of the alleged abusive events, a detailed description of the injuries, results of all pertinent lab and ...
