caring for abused persons Flashcards
phys abuse
inflict phys pain or bodily harm
sexual abuse
any form of sexual contact or exposure without consent or unable to give consent
emotional abuse
undermine self worth
neglect
fail to provide phys, emotional, edu, medical needs
economic abuse
forbid school or employment
control access, make financially dependent
crisis situaiton
put stress on fam with violent members
no impulse control, problem solving skills, healthy support system
perp
member of house biolent towards other member
vulnerable person
victim/survivor
member upon whom abuse is perpetrated
survivor v victim
recognize recovery and healing process that follows victimization, no connotation of passivity (like victim)
intimate partner violence
phys, rape, stalk, psychological aggression by current or former
intimate partner violence: rf
greatest when threaten to or actually leave
perspective dom: M believe in male dom
pathological jealousy: control, track, accompany, accuse of cheating
substance abuse: weaken inhibitions
preg -> resent, trigger or increase
cycle of violence: tension building
minor incidence: push, shove, verbal
victim decreases tension: ignore, accept, excuse behavior out of fear
abuser decreases tension: rationalize behavior, OH/substance
cycle of violence: acute battering
tension peak
triggered by events or abusers emotional state
victims start so they can move to honeymoon
cycle of violence: honeymoon
tension decreases
abuser is remorseful, apologetic, promises, gifts
victim feels needed, loved, hopeful, abandons legal plans
cycle of violence: repetition of cycle
less calm stages, increasing intensity, increasing dep and hopelessness and immobilization and self depreciation
older adult abuse
intentional actions that cause harm or create r/o harm to vulnerable person
failure to provide basic needs or protect from harm
epidemiology: unreported d/t isolation, dependency, fear of retaliation
self neglect if caring for self
older adult abuse: rf
poor mental/phys health or disruptive d/o like AD
dependency
dam with hx violence
typical victim: F, >75, live with relative, phys and/or mental impairement
assess
screen all
cm may be vague: chronic pain, insomnia, hypervent, gynecological problems
interview process: private, sit near, rapport, dont use “ abuse” “violence”, ask specific Q about conflict resolution, dont interrupt
assess: phys abuse
covert = series of minor complaints -> HA, back trouble, dizzy, accidents (esp falls)
overt = bruise, scar, burn, wounds in various stages of healing
warnings: minimize seriousness, explanation dont match, vague explanations
ask when was last time it happened, how often, how are you hurt
assess: sexual abuse
sexual behavior or knowledge, drawing explicit, sexual aggression/play/promiscuity, masturbate
s/s PTSD
assess: emotional abuse
decreased self esteem, feel adequate, anx, withdrawal, learning difficulties, poor impulse control
neglect
under nourished, dirty, poorly clothes, inadequate dental/med care (no vax)
economic abuse
needs unmet with adequate finances, unpaid bills (disconnected utilities), extreme dependency
nursing process
outcomes should be dev with survivor and primary support person
planning: nurse often first point of contact
usually community follow up
prevention
1= prevent occurance
2 = early intervention
3 = tertiary, healing, and rehab
tm
survivors and perp (CBT), best after crisis has died down
individual therapy: sense of self, empower, choose productive life
fam: perp needs individual and show progress before all
group: isolation, self worth
rape
attempted: threat or intention that is unsuccessful
completed: penetration without consent
sexual assault/violence
epidemiology
M more likely to: suffer phys trauma, victimized by multiple perps, in locked institutions
multiracial and american indian
perp usually male
sexual assault/violence: clinical picture
not typical presentaiton, emotional responses vary
long term: MDD, anx, fear, suicide, ASD, PTSD
difficulty daily F, low self esteem, sexual dysF, somatic
sexual assault nurse examiner
specialized training
med and legal competency
expert witness
part of SA response team
assess
consent!
nursing process
reassess emotional state w/n 48 hr d/c
