caring for abused persons (329 E3)

Question 1

physical abuse

Answer 1

the infliction of physical pain or bodily harm

Question 2

sexual abuse

Answer 2

any form of sexual contact or exposure without consent or in circumstances in which the victim is incapable of giving consent

Question 3

emotional abuse

Answer 3

the undermining of a person’s self worth

Question 4

neglect

Answer 4

the failure to provide for physical, emotional, educational and medical needs

Question 5

economic abuse

Answer 5

controlling a person’s access to economic resources making an individual financially dependent

Question 6

crisis situation

Answer 6

a situation that puts stress on a family with a violent member

-lack of effective impulse control
-lack of problem solving skills
-lack of a healthy support system

Question 7

perpetrator

Answer 7

any member of a household who is violent toward another member

Question 8

vulnerable person

Answer 8

the family member upon whom abuse is perpetrated

Question 9

survivor (vs. victim)

Answer 9

recognizes the recovery and healing process that follows victimization and does not have a connotation of passivity

Question 10

intimate partner violence (IPV) includes

Answer 10

physical violence, rape, and/or stalking and psychological aggression by a current or former intimate partner

Question 11

risk factors for IPV

Answer 11

-perspective dominance
-pathological jealousy
-substance abuse
-pregnancy

greatest risk is when a person threats to leave or actually leaves the relationship

Question 12

cycle of violence

Answer 12

tension building -> acute battering -> honeymoon stage
the cycle moves in a continuous circle

Question 13

cycle of violence: tension building

Answer 13

-minor incidents (pushing, shoving and verbal abuse)
-victim reduces tensions, ignores/accepts/excuses behavior out of fear
-abuser reduces tension, rationalizes behavior

abuser reduces tension of incident w/ alcohol and drugs and victim by minimizing the importance of the incident

Question 14

cycle of violence: acute battering

Answer 14

-tension peaks
-triggered by events or abuser’s emotional state

some experts believe that the victim provokes to decrease the tension and go to the honeymoon stage

Question 15

cycle of violence: honeymoon

Answer 15

-tension reduces
-abuser: is remorseful, apologetic, promises gifts
-victim: needed love, hopeful, abandons legal plans

Question 16

with the cycle of violence, overtime

Answer 16

-Decrease in calm stages
-Increase in intensity
-Increase in depression
-Increase in hopelessness
-Increase in immobilization
-Increase in self-deprecation

Question 17

older adult abuse definition

Answer 17

intentional actions that cause harm or creates a risk of harm to a vulnerable person. This mistreatment includes failure to provide for the older adults’ basic needs or to protect them from harm

all types of abuse from financial to sexual to physical

Question 18

risk factors for older adult abuse

Answer 18

-poor mental health
-poor physical health
-disruptive disorders (alzheimer’s)
-dependency
-families w/ a hx of violence

Question 19

most typical victim of older adult abuse

Answer 19

-female
-over 75
-living w/ a relative
-physical and/or mental impairment

Question 20

vague symptoms of abuse

Answer 20

-Chronic pain
-Insomnia
-Hyperventilation
-Gynecological problems

Question 21

interview process in regards to abuse

Answer 21

-Private
-Sit nearby
-Establish rapport
-Avoid words like “abuse” or “violence”
-Ask specific questions about conflict resolution
-Do not interrupt

Question 22

look at the interview guidelines box

Answer 22

DOs and DONTs

Question 23

assessing for physical abuse: covert signs

Answer 23

A series of minor complaints such as:
-Headaches
-Back trouble
-Dizziness
-Accidents (especially falls)

Question 24

assessing for physical abuse: overt signs

Answer 24

Bruises
-Scars
-Burns
-Wounds in various stages of healing: Head,
face, chest, arms, abdomen, back, buttocks,
and genitalia (Box 28.3)

Question 25

when assessing for physical abuse

Answer 25

if the explanation does not match the injury or if the patient minimizes the seriousness of the injury, expect abuse observe non verbal responses **ask in a direct non threatening manner if someone close to them has caused this injury** start to ask the questions "when was the last time it happen?" "how long as it been happening" "in what ways are you hurt"

Question 26

assessing for sexual abuse

Answer 26

Sexualized behavior - one of the most common sx in children Sexual knowledge Drawing sexual explicit material Sexual aggression Sexual play Sexual promiscuity in older children +sx of PTSD adults report depression, anxiety, a risk for suicide, aggression, chronic low self esteem, chronic pain, obesity, substance misuse, self mutilation and PTSD

Question 27

assessing for emotional abuse

Answer 27

**may exisit on its own or in conjuction w/ physical or sexual abuse** Low self-esteem Feelings of inadequacy Anxiety Withdrawal Learning difficulties Poor impulse control

Question 28

assessing for neglect

Answer 28

under nourished dirty poorly clothed inadequate medical/dental care

Question 29

assessing for economic abuse

Answer 29

Needs unmet with adequate finances Unpaid bills -> Disconnected utilities Extreme dependency

Question 30

additional assessments for abuse

Answer 30

Level of anxiety and coping response Individual & Family coping mechanisims/patterns Support systems Suicide potential Homicidal potential Drug and alcohol use Self-Assessment

Question 31

potential priority problems

Answer 31

Safety is the top priority Risk of violence Risk for suicide Anxiety, Fear, Hopelessness Low self-esteem Individual impaired coping/impaired family coping Dysfunctional family process

Question 32

outcomes for an abused pt

Answer 32

Abuse cessation is top priority Physical abuse has ceased Emotional abuse has ceased Sexual abuse has ceased Financial exploitation has ceased **make these with the survivor and their support person**

Question 33

re listen to planning & implementation

Answer 33

review plan of care slides

Question 34

preventions for abuse: primary

Answer 34

Measures taken to prevent the occurrence of abuse Examples: Reducing stress and the influence of risk factors, increasing social supports, coping skills and self-esteem

Question 35

preventions for abuse: secondary

Answer 35

Early intervention in abusive situations Examples: **Screening** programs for individuals at risk, medical treatment for injuries, coordination of community services

Question 36

preventions for abuse: tertiary

Answer 36

Occurs in MH settings; nurse facilitates healing and rehabilitation Examples: Counseling individuals and families, providing support for groups of survivors, and assisting survivors of violence to achieve their optimal level of safety, health, and well-being, legal advocacy programs for survivors of intimate partner violence, complementary therapies, such as mindfulness-based stress reduction, can also assist survivors in the healing process

Question 37

treatments: individual therapy

Answer 37

goals are the survivor feels empowerment, has the ability to recognize and choose productive life options, and the development of a solid sense of self **nurses must address the guilt, shame and stigmatization experienced by survivors of abuse**

Question 38

treatments: family therapy

Answer 38

all members need support and understanding interventions provided may maximize positive interactions amongst all family members **couples therapy can put the abuse at increased risk of harm or death -> should only happen if abuser had individual therapy first and has demonstrated change**

Question 39

treatments: group therapy

Answer 39

participation in group therapy provides assurance that one is not alone and that change is possible +CBT

Question 40

attempted rape

Answer 40

Threats of rape or intention to rape that is unsuccessful

Question 41

completed rape

Answer 41

“Penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim” (FBI, 2019)

Question 42

clinical picture of sexual assault

Answer 42

No typical patient presentation; emotional responses will vary Long-term effects may include: Major depressive disorder, anxiety, fear, and suicide Difficulties in daily functioning Low self-esteem Sexual dysfunction Somatic Complaints

Question 43

acute stress disorder caused by SA

Answer 43

**sx <1mo** -Intrusive symptoms (memories, dreams, flashbacks) -Negative thoughts, moods, feelings -Avoidance -Arousal symptoms -Disassociation

Question 44

post traumatic stress disorder caused by SA

Answer 44

**sx >1mo** -Depersonalization: Feeling like they are living in a dream -Derealization: Feeling like the world is dreamlike, distant or distorted

Question 45

sexual assault nurse examiner (SANE)

Answer 45

Specialized training Medical and legal competency Capable of being an expert witness in court Works as part of the Sexual Assault Response Team (SART)

Question 46

re listen to care plan process for SA

Answer 46

review