Abuse, Neglect, and Sexual Assault -- SD Flashcards
Every ____ seconds a woman is battered or injured
9
1 in ______ women in US report experiencing violence at some point in their life
4
Women who experience domestic violence are at risk for experiencing/developing these four things
Stroke, heart disease, asthma, alcoholism
What are common areas on the body for abuse?
Back of head, neck and shoulders, face, posterior arms, thighs, buttocks, back
What are some injuries that signify “pattern of abuse”?
injuries inconsistent with history, multiple areas, different stages of healing, symmetrical bruising
Should we use direct quotes from the victim when documenting?
yup
If a patient is 33 and they’ve been assaulted, do we have to report it? What if the patient is 16?
If they are NOT a minor, they do not have to report. If they are a minor, we as providers HAVE to report.
What is one of the most lethal forms of domestic violence?
Strangulation
What is felt to be the best predictor of future homicide victims?
Strangulation
What is the most common form of strangulation?
Manual
What structure are typically affected from strangulation?
Cartoids, jugular veins, and tracheal occlusion
Voice changes, difficult or painful swallowing, shortness of breath, and mental status changes, are all symptoms of?
Strangulation symptoms
What is a complication of strangulation?
Delayed death; carotid dissection or stroke
What are our best imaging options in terms of strangulation?
MRI or CDTA
What is a SAFE?
Sexual assault forensic examiner
Should we remove a patients clothing immediately if they are reporting sexual assault?
No – avoid removal of clothing unless acutely necessary
True or false
the word “alleged” should be in the CC?
False – very false
What should you do if a SAFE is not available?
Primary nurse and ED provider must work as a team to care for patient
What should we offer any patient of child-bearing capacity after a sexual assault?
Pregnancy prophylaxis
Plan B or Ella
What STD’s do we prophylactically treat for?
Trichomonas, Bacterial Vaginosis, gonorrhea and chlamydia, hep B, HIV
What drug do we prescribe for Trich and BV ppx?
Flagyl
What abx do we prescribe for gonorrhea and chlamydia?
Ceftriaxone and azithromycin
What type of intercourse presents the highest risk of HIV transmission
anal
Whats the biggest problem with HIV ppx?
Most patients stop taking the meds because of the extreme side effects
also hella expensive
When do we consider HIV ppx?
When we KNOW there was unprotected intercourse, when we KNOW reception of seminal, vaginal, or blood occurred, and the victim is ready and willing to complete tx
What are our two HIV ppx drugs?
Truvada and Kaletra
If the assault happened 48 hours ago can we still give HIV ppx?
Yep – not after 72 hours
What are some long-term sequelae from sexual assault?
Depression, EtOH, PTSD, 13x more likely to attempt suicide
If you suspect sexual assault you can do a forensic exam within _____ days for adults and _____ days for children.
5 days for adults
3 for kiddos
True or False
Its ok to use a speculum on a prepubescent child if you suspect assault?
FALSE
PG testing and ppx should be offered to ANY female child with sexual development at this tanner stage and above?
Tanner stage 2
Babies with low or high birthweight are more at risk for abuse?
Low
what 3 exams should always be part of your physical exam if you suspect child abuse?
Fundoscopic exam
Intraoral exam
Anogenital exam
Any bruise in an infant under ___ months without confirmed accident accounting for it is a concern for abuse
6
Assymmetric, irregular borders are more likely to accidental or non-accidental?
accidental
What two organs (in the abdomen) are most at risk for a child suffering from abuse?
Liver and small bowel
What is the most common form of elder abuse?
Neglect
