Abuse, Violence, & Neglect Flashcards
Define:
Any act of aggression with or without an object or weapon that results in injury, pain, or impairment to another
Physical Abuse
What acts are considered Physical Abuse
striking, kicking, shoving, choking, & burning
Define:
Threats, intimidation, criticizing, gaslighting, insulting, & humiliating to assert dominance & fear.
Psychological Abuse (emotional abuse)
Define:
Death, injuries, chronic stress, anxiety, depression post-traumatic stress (PTSD), substance abuse, increased risk of suicide & future victimization.
Comorbidities
Which 4 populations are at the HIGHEST risk for intimate partner violence?
- younger women
- women: divorced or separated
- Native Americans
- Alaska Native women are at the highest risk.
Common characteristics of the “Victim”
List 8
- Low self-esteem
- Accepts blame
- Feelings of fear, guilt, anger, and shame
- Isolated
- May have married young to escape abuse
- Decreased ability to see options and make decisions as abuse continues
- Reports chronic pain concerns
- History of ‘frequent accidents’
Victimizer are most often in what age range?
25 - 44 years (not exclusively)
8 Common characteristics of the “Victimizer”
- No diagnosed mental illness
- Low self-esteem
- Dual personality
- High-stress level with poor ability to cope
- Highly possessive of partner
- Abusive childhood (repeating the cycle)
- Holds power over victim (Applies to all forms of abuse) **
What are the key components of a CRISIS intervention?
- Initial interview: Focus only on the incident to avoid overwhelming the person.
- Pain control: Address physical and emotional pain to stabilize the individual.
- Coping strategies: Help the person develop skills to regain control of their life.
During the INITIAL INTERVIEW what assessment will you still perform?
comprehensive assessment
What is the #1 priority with Intimate Partner Violence
Safety!!!
Define:
Any type of sexual activity inflicted on a non-consenting person.
Sexual Violence
What is rape considered?
A crime of violence
and
domination.
A nurse is caring for a patient who has been a victim of sexual assault. Which of the following actions should the nurse prioritize to ensure the preservation of evidence?
A) Encourage the patient to change into a hospital gown immediately.
B) Collect/preserve and document a detailed history of the incident.
C) Provide the patient with a warm blanket for comfort.
D) Instruct the patient to wash their hands before the examination.
B) Collect/Preserve and document a detailed history of the incident
(Be careful to preserve evidence as best as possible)
Why is giving control back to the victim crucial for coping after sexual violence?
- Immediate Coping: Reduces feelings of helplessness.
- Long-term Coping: Helps victims feel in control of their lives.
Nursing Interventions for Sexual Violence
- Go at the client’s pace
- Report to the police (up to the victim)
- Physical Exam, Rape Kit, SANE exam, etc.
- Pain Management
- Psychosocial Support
-Initially focusing on just the incident alone - Teach Safety Measures: do this last **
Short-Term S/S of Rape Victims
- Contusions & abrasions
- Headaches, fatigue, sleep issues
- Stomach pain, N/V
- Vaginal discharge, burning urination, rectal bleeding
- Emotional: rage, humiliation, shock, self-blame
- Fear of violence & death
Long-Term S/S of Rape Victims
- Restlessness
- Nightmares
- Phobias (sexual interaction)
- Vulnerability
- Loss of control
- Flashbacks
- Feeling unclean
- Difficulty living alone
- Avoidance of assault location
a pattern of repeated unwanted contact, attention, & harassment
stalking
What can be considereed “stalking”
- Vandalizing property
- Use of technology to track or harass someone
- Sending unwanted gifts
(and the other basic things)
define:
- Threatening, intimidating, or humiliating an individual (regardless of age or
position) - Can be verbal or nonverbal
Emotional abuse
List 3 examples of verbal emotional abuse
- insults
- yelling
- threats
Emotional abuse:
Signs exhibited by children
- Extreme behavior (demanding, aggressive, passive)
- Delayed physical/emotional development
- Lack of attachment to parents
- Adult-like behavior or developmental delays
Emotional abuse:
Main sign exhibited by the adult
no care for child
Child abuse vs neglect:
Acts that are intentionally harmful behaviors & include
physical, sexual, & psychological abuse.
Child Abuse
Child abuse vs neglect:
acts of omission for a child’s basic physical, emotional,
educational, & health care needs are not met.
Child Neglect
What children are at HIGHEST risk for abuse & neglect
List 3
- younger than 4yr. old
- unwanted pregnancies
- have developmental or physical disabilities.
What kind of ‘deviations’ are considered red flags?
deviations from normal child development, or in the story & the injury
During a routine check-up, a child is found to have a spiral fracture in addition to multiple other fractures. What should the nurse suspect regarding the child’s injuries?
A) The fractures are likely the result of an accidental fall.
B) The child may have a medical condition affecting bone strength.
C) The pattern of fractures raises concern for potential child abuse.
D) The injuries are consistent with normal childhood activities.
C) The pattern of fractures raises concern for potential child abuse.
Which of the following findings in a child’s assessment would raise suspicion for child abuse?
A. Multiple bruises in various stages of healing on the back and belly
B. A single bruise on the arm from a fall
C. Bruising on the legs consistent with typical childhood play
D. A few small scratches from rough play
- Multiple bruises in various stages of healing on the back and belly.
4 main signs of CHILD ABUSE
- Injuries in various stages of healing
- Fading bruises or marks noticeable after an absence from school
- Seems frightened of parents and protests or cries when it is time to go home
- Abuses animals or pets
Reports of inconsistent developmental milestones in a child may suggest?
potential child abuse or neglect if the milestones do not match the expected level of progression for their age.
- if a child’s abilities and behaviors don’t match what we expect for their age, based on what parents or caregivers say, it might indicate that something is wrong. This could include concerns about the child’s development and possibly point to issues like abuse or neglect.
Child emotional abuse vs. child abuse
- emotional abuse: child has aggressive behaviors, acts like adults, lack of attachment to parents
- child abuse: child friighten of parents, cries when going home, abuses animals/pets
What is Shaken Baby Syndrome (SBS)
- Serious brain injury that occurs when a baby is violently shaken, leading to shaking-induced trauma.
- This can cause severe damage to the baby’s brain, eyes, and spine.
S/S of Shaken Baby Syndrome (SBS)
- Retinal hemorrhage & detachment
- Poor eating, sucking, swallowing
- Tremors
- Pale or bluish skin
- Seizures
- Paralysis
- Coma
Signs of SEXUAL abuse on Victim
List 4
- Pain in body
- Poorly in school
- reacts angrily to sexual acts
- Draws, uses toys or acts out sexual acts
- biting nails or pulling hair when stressed
- Demonstrates bizarre, sophisticated, or unusual sexual knowledge
or behavior
Signs exhibited by the abuser
- Overly protective of child & severely limits child’s contact with other children, especially of the opposite sex
- Secretive & isolated
- Jealous & controlling with family members
Behavior signs of CHILD NEGLECT
- Learning difficulties
- Inappropriate coping mechanisms
- Fatigue
- Stealing or hoarding food
- Excessive absence or tardiness in school
Most common abuse in Elderly
financial abuse
Who is considered a “high-risk abusers’ for the elderly
- those using drugs, alcohol
- high stress
- finical dependence on the older adult
- lack training for caregiving of an older adult
- depression
For adult abuse who do we report to
Adult protective services
What is a common reason victims of financial abuse may stay in the relationship?
Victims often stay for fear of not being able to provide for themselves or their children
No.1 reason why WOMEN return to an abusive partner
financial insecurity
What is the “Cycle of Violence”
a concept that describes the recurring pattern of behavior in abusive relationships, often seen in cases of domestic violence.
Cycle of Violence:
What is the 1st Phase called?
Tension Building
What occurs in the Tension Building phase
- Perpetrator establishes total control of victim by psychological and emotional means
- Verbl abuse follows
- Perpetrator monitor victims activities
- Perpetrator minimizes victim
Cycle of Violence:
What is Phase 2 called?
Violence Erupts
Cycle of Violence:
What occurs in Phase 2?
- Sever injury to victim/children
- victim may incite violence as a means of coping with their overwhelming fear
- Period of relative calm follows battering
Cycle of Violence:
What is Phase 3 called?
Remorse Ensues
What happens in Phase 3
- Perpetrator becomes kind, contrite and loving
- Promises never to be violent again
- Tension builds; cycle repeats
Nurses are ___ reporters.
MANDATORY
Can a nurse delegate reporting an abuse?
No. Nurse has to report themselves
Texas Nurses are legally required to report all suspected cases of abuse and neglect within
48 hrs of occurence
1st thing the nurse would do for a suspected or abused patient?
Assess & treat the wounds
AFTER assessing and treating the wounds, what is the Nurse’s 2nd step?
Ensure the victim is removed from the threatening environment
Who should you notify when encountering a situation of abuse or concern with a patient?
2 people
- Notify the charge nurse
- Case worker
How should documentation be conducted for cases of abuse or injury?
Should be METICULOUS & OBJECTIVE
(Thorough physical assessment)
What type of therapy may help children express their feelings?
play therapy (dolls, toys, colloring)
How should parents or caregivers be addressed when discussing concerns about the child?
Non-threatening and non-judgmental manner
What important detail should you pay attention to in the victim’s or caregiver’s stories?
inconsistencies in stories
When assessing information provided about a child in an abuse situation, compare this infromation given to
the DEVELOPMENTAL AGE of the child.
Define:
a serious crime that involves the exploitation of individuals for labor or commercial sex purposes.
Human Trafficking
What must nurses clarify to the patient during an assessment regarding abuse?
must inform patients about their duty to report suspected abuse or neglect (mandated reporting)
What 2 specific situations should healthcare providers be wary of concerning potential exploitation?
- Runaway or homeless youth – greater incidence of “survival sex,” where sexual acts are exchanged for basic necessities.
- Recent immigrants – withholding documentation/fear of deportation used as powerful coercion tactics.
