During a pediatric assessment, bruises are noted on concealed surfaces at various healing stages. What action should the nurse take next?

• A. Contact the local reporting agency for suspected child abuse
• B. Wait for more evidence
• C. Document for later only
• D. Transfer the child to another unit

Answer: (A)

Bruising on areas not typically exposed and at multiple stages of healing strongly suggests non-accidental trauma. As a nurse, you are a mandated reporter, so the immediately appropriate action is to contact the local reporting agency for suspected child abuse. This initiates the necessary protective and investigative steps to keep the child safe. Do not delay for more evidence, and do not document for later only or transfer the child without following the reporting protocol. Alongside reporting, document objective findings carefully (exact locations, sizes, colors, and estimated ages of the bruises) and follow facility procedures to ensure the child’s safety.