An emergency nurse is caring for an 8-year-old child with a spiral fracture of the humerus. The caregiver states the child fell off a bicycle. The nurse notes that the child avoids eye contact and seems fearful of the caregiver. Which action is the nurse's legal priority?
Report the suspected child abuse to Child Protective Services.
Confront the caregiver about the suspicion of abuse.
Discuss the inconsistencies in the caregiver's story with the charge nurse.
Thoroughly document the objective findings and the caregiver's explanation.
The nurse's legal priority is to report the suspected abuse to the appropriate authorities, such as Child Protective Services. Nurses are mandated reporters, and the combination of a spiral fracture (often associated with a twisting injury), a questionable mechanism of injury, and the child's fearful behavior constitutes reasonable suspicion of abuse. While documenting findings is essential, reporting cannot be delayed. Confronting the caregiver can escalate the situation and endanger the child. Discussing the situation with a charge nurse is a good step, but it does not replace the individual nurse's legal duty to report.
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