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NURS 414: OB > Chapter 30Vulnerable Populations > Flashcards

Chapter 30Vulnerable Populations Flashcards

Exam 4 (Final)

1
Q

Sexual Assault: What is it?

A

Sexual violence is unwanted sexual experiences, unwanted sexual contact, and sexual coercion.

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2
Q

Sexual Assault:

How many people report being sexually harassed in public ?

A

One-third of females and 1 in 9 males report being sexually harassed in public

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3
Q

Sexual Assault:

How many people have reported rape and sexual assault to the police?

A

In 2021, fewer than 22% of rape and sexual assault survivors reported the crime to the police.

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4
Q

Sexual Assault:

Because nurses are mandated reporters, what does this mean?

A

Nurses are mandated reporters, and it is the responsibility of the nurse to know the reporting requirements in their state.

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5
Q

Sexual Assault:

Ideally, when should sexual assault examination occur?

A

Ideally, a sexual assault examination should take place within 72 hours.

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6
Q

Sexual Assault:

What kind of nurses about examine patients?

A

Often nurses certified as SANE (Sexual Assault Nurse Evaluation) nurses examine patients.

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7
Q

Sexual Assault: Patient History

What are Patient history topics to address after an assault:

A

Personal hygiene activities since the assault (e.g., showering)

Circumstances of the assault

Loss of consciousness or memory

Physical description of the assault

Specifics of the assault (oral, anal, or vaginal contact; ejaculation; and condom use)

Other areas of trauma

Bleeding by the victim or assailant

Recent consensual sex

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7
Q

Sexual Assault:

What kind of training do SANE nurses have?

A

SANE nurses have specialized training in interviewing and collecting evidence after a sexual assault.

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8
Q

Sexual Assault: Patient History

What must the interviewer be careful doing?

A

The interviewer must take great care to avoid any type of victim blaming or judgment.

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9
Q

Sexual Assault: Prophylactic Care #1

After an assault, what are individuals tested for?

A

After an assault, individuals are tested for sexually transmitted infections and pregnancy.

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10
Q

Sexual Assault: Prophylactic Care #1

What kind of result are not likely after a assault? Why?

A

Positive results are not likely a result of the assault due to incubation periods.

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11
Q

Sexual Assault: Prophylactic Care #1

When is treatment given?

A

Treatment is usually given at the time of the assault, prior to receiving a positive result.

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12
Q

Sexual Assault: Prophylactic Care #1

What is indicated after an assault?

A

Emergency contraception is indicated as soon as possible after an assault.

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13
Q

Sexual Assault: Prophylactic Care #2

What are individuals tested for? What are they started on?

A

Individuals are often tested for hepatitis B immunity, started on the vaccine series, or received hepatitis B immune globulin if the perpetrator is known to have hepatitis B.

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14
Q

Sexual Assault: Prophylactic Care #1

What should be done 2-3 weeks after an assault?

A

A pregnancy test should be taken if the patient misses a period 2 to 3 weeks after an assault.

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15
Q

Sexual Assault: Prophylactic Care #2

What are individuals usually treated for and why?

A

Because of the high risk of exposure and infrequent follow-up visits, individuals are often treated for gonorrhea, chlamydia, and trichomoniasis after an assault.

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16
Q

Sexual Assault: Prophylactic Care #2

When is HIV nonoccupational postexposure prophylaxis (nPEP) most effective? When is it not effective?

A

HIV nonoccupational postexposure prophylaxis (nPEP) is most effective if started 4 hours after exposure and not effective if started after 72 hours.

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17
Q

Sexual Assault: Prophylactic Care #2

How long does treatment with HIV nonoccupational postexposure prophylaxis (nPEP) last? What does it consist of?

A

Treatment with nPEP lasts for 28 days and consists of medications used to treat HIV.

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18
Q

Sexual Assault: Prophylactic Care #2

When are HIV and syphilis testing done after an assault?

A

HIV and syphilis testing should be done at 4 to 6 weeks and 3 months after an assault.

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19
Q

Sexual Assault: Prophylactic Care #3

What should survivors between 9 and 26 receive? When would they not receive this?

A

Survivors of sexual assault between the ages of 9 and 26 should receive the human papillomavirus vaccine (HPV), unless previously received.

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20
Q

Sexual Assault: Prophylactic Care #3

What should nurses offer survivors?

A

Nurses should offer mental health services to all survivors of sexual assault.

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21
Q

Sexual Assault: Prophylactic Care #3

Survivors of sexual assault are at risk for:

A

Posttraumatic stress disorder
Depression
Insomnia
Anorexia
Suicidality

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22
Q

Sexual Assault: Prophylactic Care #3

Sexual assault resources for patients can be accessed where?

A

Sexual assault resources for patients can be accessed at RAINN: www.rainn.org, (802) 656-HOPE.

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23
Q

Intimate Partner Violence (IPV) #1:

What is it?

A

IPV is any actual or threatened psychological, sexual, or physical harm of one current or past partner by the other.

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24
Q

Intimate Partner Violence (IPV) #1:

How many people experience it?

A

Approximately 1 in 10 males and 1 in four females experience IPV in their lifetimes.

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25
Q

Intimate Partner Violence (IPV) #1:

What is a feature of IPV?

A

A feature of IPV includes power of one partner over another.

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26
Q

Intimate Partner Violence (IPV) #1:

What is critical to have before someone reveals IPV?

A

Trust is critical. It often takes several encounters before a person discloses IPV.

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27
Q

Intimate Partner Violence (IPV) #1:

How are most victims of IPV?

A

Most victims of IPV are not in immediate danger, but safety must be assessed.

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28
Q

Intimate Partner Violence (IPV) #1:

What is safety planning?

A

Safety planning is an attempt to reduce the risk of escalating violence and may include a signal to alert others to contact emergency services (an emergency kit, information for shelters).

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29
Q

Intimate Partner Violence (IPV) #1:

What can happen if the abuser finds the safety information?

A

Keep in mind, safety information can be helpful but can endanger the victim if discovered by the abuser.

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30
Q

Intimate Partner Violence #2

How are mandating reporting by state?

A

Mandated reporting requirements vary by state and situation.

31
Q

Intimate Partner Violence #2

What should documentation of abuse include?

A

Documentation of the abuse is important and should include physical examination findings and the patient’s report of the abuse.

32
Q

Intimate Partner Violence #2

What are long term consequences of IPV in victims?

A

IPV victims may have long-term consequences such as posttraumatic stress syndrome, anxiety, suicidality, eating disorders, or chronic pain.

33
Q

Intimate Partner Violence #2

Risk factors for the escalation of IPV:

A

When the victim seeks to leave the relationship, seeks help, or is afraid for one’s life.

When the victim is suicidal or homicidal.

When the perpetrator threatens to kill one’s self, victim, or children.

When the perpetrator is violent outside the home, uses drugs, or owns weapons.

34
Q

Intimate Partner Violence #3:

What are Helpful statements:

A

“I am so sorry this is happening.”

“This is not your fault.”

“I can help connect you with people and resources that can help you when and if you’re ready.”

“This is not an uncommon problem. You are not alone.”

35
Q

Intimate Partner Violence #3:

What are Unhelpful statements:

A

“What do you think is wrong with you that you get into these situations?.”

“If it is so bad, why do you stay?.”

“I would never let anyone hurt me like that.”

36
Q

Human Trafficking: What is it?

A

Human trafficking is the recruitment, transportation, transfer, harboring or receipt of people through force, fraud or deception, with the aim of exploiting them for profit.

37
Q

Human Trafficking:

How many people?

A

In 2016, it was estimated that 24.9 million people were forced into unpaid labor and 4.8 million of these were forced sex workers.

38
Q

Human Trafficking:

What do human trafficking victims face?

A

Human trafficking victims face frequent health problems and report seeking the use of healthcare services.

39
Q

Human Trafficking:

How do some victims view themselves?

A

Some victims may not recognize themselves as human trafficking victims.

40
Q

Human Trafficking:

What are victims and caretakers at risk for? What must be done?

A

Victims of human trafficking and those who care for them are at risk for harm from traffickers. Care should be taken to maintain confidentiality and clinic security.

41
Q

Human Trafficking:

What is required in care?

A

Careful documentation is required.

42
Q

Human Trafficking:

What should be done with resources given to them?

A

Patients are not always able to leave once identified. Resources given to them should be memorized if possible.

43
Q

Human Trafficking: Red Flags

How is history?

A

Shares a scripted or inconsistent history

44
Q

Human Trafficking: Red Flags

How open are they about injury or illness?

A

Is unwilling or hesitant to answer questions about the injury or illness

45
Q

Human Trafficking: Red Flags

Who are they accompanied by?

A

Is accompanied by an individual who does not let the patient speak for themselves; refuses to let the patient have privacy, or interprets for the patient

46
Q

Human Trafficking: Red Flags

How would a victim behave/show signs of?

A

Exhibits signs of being in controlling or dominating relationships (excessive concerns about pleasing a family member, romantic partner, or employer)

Demonstrates fearful or nervous behavior or avoids eye contact

47
Q

Human Trafficking: Red Flags

How can victims react to help?

A

Is resistant to assistance or demonstrates hostile behavior

48
Q

Human Trafficking: Red Flags

What do victims not have?

A

Is unable to provide their address or is not in possession of their identification documents

Is not aware of their location, the current date, or time

Is not in control of their own money or is not being paid or has wages withheld

49
Q

Incarcerated Patients #1

How many females are incarcerated?

A

As of 2020, almost 80,000 females were incarcerated in the United States.

50
Q

Incarcerated Patients #1

What should females who are incarcerated be tested for?

A

All females who are incarcerated should be tested for pregnancy at the time of incarceration.

51
Q

Incarcerated Patients #1

What is the expectation of pregnant incarcerated females?

A

The expectation is that the pregnancy/postpartum care of females who are incarcerated is the same as for females who are not incarcerated.

52
Q

Incarcerated Patients #1

What can be a barrier to care for incarcerated females?

A

Logistics can be a barrier to care (e.g., transportation, follow-up, and care of the newborn).

53
Q

Incarcerated Patients #1

Females who are incarcerated have a higher risk of what?

A

Females who are incarcerated have higher risk for pregnancy complications.

54
Q

Incarcerated Patients #2

Intrapartum care should include:
What should nurses be aware of?
Who may have to be in the room?

A

Nurses should be aware that shackles increase the risk of a fall.
A corrections officer may be required in the room.

55
Q

Incarcerated Patients #2

Postpartum care should include:

Few facilities have what?

A

Few facilities having available accommodations for infants on site.

56
Q

Incarcerated Patients #2

Postpartum care should include:

What often happens to infants?

A

Infants often given to family, foster care, or adoption.

57
Q

Incarcerated Patients #2

Postpartum care should include:

What should be discussed with patient?

A

Contraception should be discussed and initiated.

58
Q

Incarcerated Patients #2

Postpartum care should include:

What happens to females after prison release?

A

About half of females released from incarceration become pregnant within 3 months.

59
Q

Incarcerated Patients #2

Care after incarceration should include:

A

Most sentences for females are brief, follow-up appointments should be made prior to release to avoid a gap in treatment.

60
Q

Patients With Eating Disorders: Anorexia Nervosa

Diagnosis of anorexia nervosa is made when:

A

Calorie restriction below requirement for weight maintenance

Profound fear and anxiety about being overweight

Distorted and disproportionally important perception of body weight

61
Q

Patients With Eating Disorders: Anorexia Nervosa

Treatment for anorexia nervosa includes:

A

Psychotherapy

Nutritional rehabilitation

62
Q

Consequences of Anorexia Nervosa

A

Slide 15

63
Q

Patients With Eating Disorders: Binge Eating Disorder

What is it?

A

Binge eating disorder is frequent bouts of overeating without inappropriate compensatory behaviors such as purging or excessive exercise.

63
Q

Patients With Eating Disorders: Binge Eating Disorder

What is considered binging?

A

Binging is generally considered to be consuming the equivalent of two or more meals or 2,000 calories or more within a given period of time (such as 2 hours) at least once a week for at least 3 months.

64
Q

Patients With Eating Disorders: Binge Eating Disorder

What is it often associated with?

A

Often associated with mental health diagnosis such as substance abuse, stress, anxiety, PTSD, borderline personality, or mood disorder.

65
Q

Patients With Eating Disorders: Binge Eating Disorder:

What are treatment goals?

A

Treatment goals include reducing the number of binge eating episodes and weight loss.

66
Q

Patients With Eating Disorders: Binge Eating Disorder:

How is it treated specifically?

A

Often treated with psychotherapy and pharmacotherapy (such as selective serotonin reuptake inhibitors).

67
Q

Patients With Eating Disorders: Bulimia Nervosa

What is it?

A

Bulimia nervosa is recurrent binge eating with inappropriate compensatory behaviors (e.g., purging, excessive exercise, and laxative diuretic use,) at least weekly for a minimum of 3 months.

68
Q

Patients With Eating Disorders: Bulimia Nervosa

What is the median age for developing?

A

Median age for developing bulimia nervosa is 20 years.

69
Q

Patients With Eating Disorders: Bulimia Nervosa

What does it often occur with?

A

Often co-occurs with mental disorders such as depression, anxiety, body dysmorphic disorder, PTSD, phobias, social anxiety, or substance abuse disorder.

70
Q

Patients With Eating Disorders: Bulimia Nervosa

What is treatment?

A

Treatment includes psychotherapy, nutritional rehabilitation, and the use of medications.

71
Q

Patients With Eating Disorders: Bulimia Nervosa

What are the goals of treatment?

A

Goals of treatment is to stop or significantly reduce the episodes of binge eating and the compensatory behaviors.

72
Q

Patients With Eating Disorders: Bulimia Nervosa

What are first line drugs for this disorder?

A

Selective serotonin reuptake inhibitors are the first-line pharmaceutical for this population.

73
Q

Consequences of Bulimia Nervosa

A

Slide 18

NURS 414: OB (15 decks)

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