1229 Exam 6 Family Violence

Question 1

What is Anger?

Answer 1

an emotional response to the perception of frustration of desires, threat to one’s neds, or challenges.

Question 2

What is aggression?

Answer 2

is harsh physical or verbal action that reflects rage, hostility, and potential for physical or verbal destructiveness.

Question 3

Anger and Aggression:

Answer 3

are the last two stages of a response that begins with feelings of vulnerability followed by uneasiness.

Question 4

General Assessment:

Answer 4

-identify anxiety before it escalates to anger and aggression
-expressions of anxiety and anger look quite similar— increased rate and volume of speech, increased demands, irritability, frowning, redness of face, pacing twisting hands, or clenching and unclenching of fist.
should include taking an accurate history of -the patient’s background, usual coping skills, and perception of the issue.

Question 5

self assessment:

Answer 5

how we intervene safely depends on our own self-awareness.

• nursing responses to angry patients can escalate along a continuum similar to that of patients.
• the more a nursing intervention is prompted by emotion, the less likely it is to be therapeutic.
• nurses’ responses reflect norms from their families or origin, personal issues, and situational events.

Question 6

What techniques beside self-assessment could be used?

Answer 6

deep breathing
muscle relaxation
empathetic interpretation of patient’ distress
review of intervention strategies can be helpful

Question 7

Social Isolation

Answer 7

family members keep to self
no invitations to the home
no sharing of information or friends
abusers may threaten if they tell
tell them that parent, siblings, or pets will die.
child will keep secret due to fear.

Question 8

Abuse of Power and COntrol

Answer 8

abusive family member in position of power over the victim.
economic and social as well as physical power
onl one who can make decisions about money or time spent outside the home.
any indication, real, or imagined, of the victim having been disobedient or trying to be independent leads to violence.

Question 9

Substance Abuse

Answer 9

Alcohol is frequently associated with family violence.

Question 10

Transmission process

Answer 10

patterns of violence from one generation to another –role modeling–social learning

• learned patten of behavior
• children who see violence between their parents learn violence is a way to solve conflicts

Question 11

Cultural factors:

Answer 11

immigrant women are more at risk to be in abusive home.

Question 12

The abusive person is more likely to what?

Answer 12

use drugs or alcohol.
Alcohol lowers their inhibitation–make the violent behavior more intense and frequent
major factor in rape cases and sexual assault.

Question 13

Family structure for conditions for Violence:

Answer 13

perpetrator (abuser)
vulnerable person
crisis situation.

Question 14

The perpertrator:

Answer 14

lacks role models and did not learn problem solving skills
-cares only about their own needs
-dissatisfied with life
-low selfesteem
witnessed family violence/experienced it
poor social skills/no support from outside marriage
-poor impulse control
substance abuser
emotionally immature— needy, irrational, jealous, possessive

Question 15

Vulnerable person

Answer 15

the one in the family that is abused–age or situation make vulnerable (children, women, elderly, mentally ill or physically challenged person or child

Question 16

crisis situation

Answer 16

stressful event–something that taxes their coping skills.
financial stress
job stress (no job)
marital problems (soldier’s families, away from home, increased stress on remaining parent.

Question 17

Risk factors for violence:

Answer 17

pregnancy
single
drugs
no support
finances
elderly

Question 18

types of abuse:

Answer 18

physical 
sexual
emotional/psychological
neglect
economic
financial

Question 19

Coping mechanisms of the abusers:

Answer 19

projection
displacement
passive aggressive
denial

Question 20

Projection

Answer 20

the world is unfair
blame someone else for their difficulties
“My boyfriend made me drink.”

Question 21

Displacement

Answer 21

Discharge our feelings o a less threatening object

Transferred to someone other than who they are angry at.

Question 22

Passive Aggressive:

Answer 22

underminers
deny they are angry but deep down they really are
afraid of rejection or punishment
passive

Question 23

Denial

Answer 23

unconscious behavior

an alcoholic who says he can control his drinking–doesnt want to see or face the problem.

Question 24

physical violence

Answer 24

battering and physical endangerment

Question 25

sexual violence

Answer 25

any sexual approach or act, explicit or implicit, toward a child. the sexual abuse of adults is usually catergorized as sexual assault or rape

Question 26

emotional violence

Answer 26

infliction of mental anguish

Question 27

neglect

Answer 27

physical, developmental, or educational

Question 28

economic maltreatment

Answer 28

using another's recources without permission for one's own personal gain

Question 29

tension building stage:

Answer 29

minor incidents (pushing or verbal abuse)

Question 30

acute battering stage:

Answer 30

perpetrator releases built up tension by beating a vulnerable person

Question 31

honeymoon stage

Answer 31

perpetrator feels remorse and acts in kindly, loving ways by apologizing or bringing gifts

Question 32

tension building state:

Answer 32

abuse recurs and cycle begins again.

Question 33

Abusers usually...

Answer 33

grow up learning that violence is normal -works out bad feelings with violence -abuses alcohol and drugs traditional ideas about what a man/woman should be -jealous of other relationships -access to guns, knives, and other lethal instruments -expects the wife to follow orders/advice -extreme highs and lows -has bad temper -treats the wife roughly.

Question 34

What are secondary effects of violence?

Answer 34

anxiety depression suicide *can last a life time.

Question 35

what are the four stages of abuse?

Answer 35

tension building stage acute battering stage honey moon stage tension building stage

Question 36

Child abuse:

Answer 36

``` * the intentional injury of a child* all socioeconomical levels mandated to report most common form "neglect" failure to provide food, clothes, shelter, supervision ```

Question 37

special parent:

Answer 37

history of abuse as a child, lacking self esteem, lack of parenting skills, poor impusle control

Question 38

special child:

Answer 38

handicapped, chronically ill, hyperactive, or have special meaning attached to the child

Question 39

stressful situation

Answer 39

parental stress or crisis situation frequently precipitates battering. social isolation and fewer supportive type relationships

Question 40

warning signs of abuse:

Answer 40

physical evidence- injuries including prior ones conflicting stories from parents/others blaming of siblings injury inconsistent with history inappropriate parental concern for the degree of injury--exaggerated or unemotional or mad at the child for getting hurt. refusal to sign in for additional/necessary treatment repeated emergency department visits delay in seeking treatment--coming to the emergency department a long time after incident

Question 41

inappropriate response of child

Answer 41

``` fear apprehension pain response regression/habitual behaviors sleep problems fear of being touched acting out in class ```

Question 42

Shaken baby syndrome

Answer 42

Head trauma retinal hemorrhage **SBS

Question 43

Munchausen's Syndrome by Proxy

Answer 43

caused by parent or fabricated illness not easily explained phsiologically occurs while alone with parent often medicaly sophisticated * The mother seeks attention by making the child sick or appear to be sick.

Question 44

Munchausen's Syndrome looks like:

Answer 44

chronic poisoning of the child suffocating the child put blood feces in the child's urine to look like an infection contaminaton of food requirng IV fluids give emetics to cause vomiting give cathartics to cause diarrhea claim sexual abuse against the other parent--"child's protector"

Question 45

Munchausen's syndrome...

Answer 45

symptoms improve in the hspital and worsen at home. -blood in lab specimens do not match the patients -parent is too enthusiastic; too helpful -pay careful attention to the history of the illness and how the parent and child interact can aslo be nurses..

Question 46

When working with abusive situations with children;

Answer 46

be non confronting and non threatening as possible ask how the parents discipline try to find out as much as you can

Question 47

Misdiagnosis: Don't confuse or misdiagnose other conditions with abuse. What conditions are easily misdiagnosed?

Answer 47

``` hemophillia/bleeding disorders SIDS osteogenesis mongolian spots coining ```

Question 48

symptoms of sexual abuse:

Answer 48

difficulty walking/sitting ton,stained,bloody underwear pain, itching of genitals STIs and or recurrent UTI unwillingness to change clothes or participate in gym activites bruises, bleeding in genital or rectal area poor peer relations exvessive interest in sexual matters-masturbation more advanced knowledge than would be expected for thier age

Question 49

sexual abuse in children

Answer 49

``` bedwetting frequent crying excessive bathing avoidance of family/peers promiscuity exvessive masturbation regressive behaviors poor school performance drug/alcohol abuse suicide attempts runaways self mutilation ```

Question 50

Typical abuser:

Answer 50

most people abused know the abuser. | it is often a parent or family member.

Question 51

child neglect:

Answer 51

failure to provide for the basic needs as physical emotional and educational needs.

Question 52

Documentation

Answer 52

chart objectively. location, size, shape, and color of injury distinguish characteristics. (shape of hand, fingers, objects) body outline/body map--draw it

Question 53

What is the most important criteria upon which to base the decision to report suspected abuse?

Answer 53

look for incompatibility between the history and the injury

Question 54

What is battering?

Answer 54

coercive behavior used to gain power and control over another.

Question 55

Stages of Battering******* | KNOW

Answer 55

phase 1: tension building phase 2: event/acute battering/violent behavior pase 3: calm/honeymoon/remorse/contrition

Question 56

The acronym "SAFE:

Answer 56

s--stress safety a--are you afraid; is anyone abusing you? f--family friends siblings parents aware? could you tell them and get support? e-- emergency plan

Question 57

Check list for leaving an abuser:

Answer 57

``` ID personal papers funds keys communication medications coping (keepsakes) ```

Question 58

3 basic catergories for elder abuse:

Answer 58

domestic institutional self-neglect/self abuse

Question 59

Forms of elder abuse:

Answer 59

``` physical sexual emotional neglect--most common abandonment financial/material ```

Question 60

Rape:

Answer 60

rape is not sexually motivated. the desire is to have power, control, and humiliate th victim. It has NOTHING to do with sex.

Question 61

Identified risk:

Answer 61

age--all ages race--most are within the race sex-- most are female, but males are usually younger victimized by older males occupation--most are students or women who work alone.

Question 62

classifcations of rapist:

Answer 62

power anger sadistic

Question 63

power rapist:

Answer 63

compensates for feelings of inadequacy and incompetence with no intent to do harm other than the rape.

Question 64

anger rapist

Answer 64

physically brutal with intended rage and retaliation against women

Question 65

sadistic rapist:

Answer 65

sees sexual abuse of the vicitm as gratifying and exciting. may use bizarre ritualistic behavior or torture in extreme cases murder

Question 66

phases of rape trauma syndrome:

Answer 66

A. Immediate/ acute (IMPACT) post traumatic stress disorder (PTSD) B. recoil--struggling to adapt C> reorganization phase Goal: move from victim to survivor status