An eight-month-old infant recently had a seizure and is lethargic and bradycardic upon arriving at the emergency room. The clinical exam revealed a retinal hemorrhage. The nurse suspects that the child is showing signs and symptoms of:

Shaken baby syndrome

Explanation

•Characteristic signs of shaken baby syndrome include retinal hemorrhages, multiple fractures of long bones, and subdural hematomas. There is usually no external signs of injury.

•Risk factors include parental substance abuse, unrealistic expectations for the child, and high levels of emotional stress.

•Incorrect: If there is a fall or bump to the head a mastoid fracture is possible, but the nurse suspects that the cause of the injury is shaken baby syndrome.

•Incorrect: Munchausen Syndrome by proxy occurs when a caregiver exaggerates, misrepresents, or forces symptoms to occur in those for whom they are caring. Often it is done for attention or sympathy.

•Incorrect: Sexual abuse must be suspected when there are bruises, bleeding, lacerations or irritation of the external genitalia, anus, mouth, or signs of verbal abuse.

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