Chapter 9/10 IPV & Flashcards
Does the rate of violence against a female increase or decrease when she becomes pregnant?
increase and can include the postpartum phase as well
Half of all murders against women are committed by whom?
intimate partners
T or F: There are as many animal shelters in the US as there are battered women shelters
False, the US has three times as many animal shelters as it does battered women shelters
what does IPV stand for? definition provided
Intimate partner violence: actual or threatened physical or sexual violence or psychological/emotional abuse
What are the four categories of risk factors for IPV in men? examples provided
1) individual factors (eg young age, heavy drinking, depression, mental health issues, witnessing violence as a child, low income)
2) relationship factors: marital conflict, economic stress, dysfunctional family, cohabitation
3) community factors: weak sanctions against IPV, poverty, low social capital
4) societal factors: traditional gender norms, social norms supportive of violence
Violence is a _________ behavior that is passed from one generation to the next
learned
Why are children of parents experiencing IPV more likely to become abusers or abused themselves?
They see abuse as an integral part of a close relationship
What is the name for the continuum of abuse/violence from one generation to the next? What are the three phases?
the cycle of violence with three phases
1) the tension-building phase
2) the acute battering phase
3) the honeymoon phase
- this cycle increases in frequency/severity as it repeats with the honeymoon phase gradually shortening then disappearing
What is often internalized by an abuse victim of IPV during the tension-building phase?
that the abusive partner’s anger/bad mood is their fault
during which phase is the victim likely to be murdered? what is internalized here?
phase 2: the acute battering phase, that they were lucky not to be abused worse and deny what is going on
What’s the longest phase?
phase 1: the tension-building phase
What are the types of abuse?
1) Emotional abuse
2) Physical abuse
3) Financial abuse
4) Sexual abuse
What is battered woman syndrome?
victims rarely describe themselves as abused, often they seem themselves as flawed/inadequate which is reinforced by their abuser
What is the strongest indicator of abuse during pregnancy?
prior abuse
what is a nursing tool to screen for violence?
the SAVE Model
Screen all your clients for IPV
Ask direct questions in a Nonjudgemental way
Validate the client by telling her
Evaluate, educate, and refer this client
SAVE questions (this is for my personal use)
Screen (pretty self-explanatory)
Ask direct questions
- avoid emotional reactions
- never use language that blames the woman (she might blame herself, dissuade her from this)
Validate
- you believe and don’t blame her
- tell her she’s brave
- talking is a big first step
Evaluate
- what type of violence was it
- is she now in any danger
- how is she feeling now
- does she know that there are consequences to violence
- is she aware of community resources available to help her
what tool is used to assess potential homicidal behavior in an ongoing abusive relationship
The danger assessment Tool
- uses presence of risk factors to assess like increased frequency of abuse, presence of firearms, substance abuse, suicide threats/attempts
an idea for screening IPV at clinic
keep a camera on premise to take pictures of abuse injuries (remember informed consent)
What are the three categories of nursing goals when encountering an abused woman (think levels of care)
1) Primary prevention: aimed at breaking abuse cycle through community educational initiatives by community members
2) Secondary prevention: focuses on dealing with victims and abusers in early stages with goal of preventing progression of abuse
3) tertiary prevention: activities geared towards severely abused to help them recover (usually long-term and expensive)
what is the tool by Holtz and Furniss that can help provide a framework for providing sensitive nursing interventions
ABCDES
A is reassuring the woman that she is not ALONE
B is expressing the BELIEF that violence against women is not acceptable in any situation/not her fault
C is confidentiality, interview in private
D is documentation
E is education about cycle of violence and resources
S is safety, use resources
What is the National Domestic Violence hotline number?
1(800)799-7233
What does a woman who’s planning to leave an abusive relationship need?
a safety plan
what is the most common date rape drug? name 2 others
Rohypnol is the most common
GHB, ketamine
What are the three groups of PTSD symptoms?
1) intrusion: reexperiencing the trauma
2) avoidance: avoiding trauma-related stimuli, emotional numbing
3) hyperarousal: increased emotional arousal
What are the four phases of rape recovery?
1) acute phase (disorganization)
2) outward adjustment phase (denial
3) reorganization: attempt life adjustments to cope
4) integration and recovery: survivor begins to feel safe and starts to trust others; she may become an advocate for other rape victims
what’s the difference between EC and mifepristone
EC: high dose of regular oral contraceptive that prevents implantation/fertilization/ovulation
mifepristone (RU-486): abortion PO within first 49 days of gestation
when is EC most effective? how does it become less effective?
most: within 12 hours of sexual assault
then becomes less effective with every 12 hours
what’s the difference between FGC type I, II, III, and IV
type I: surgical removal of clitoris
type II: removal of clitoris and labia minora
III: removal of clitoris, labia minora and majora and suturing remaining tissue known as fibulation with small opening for functioning
IV: includes scraping, burning, with aim of tightening or narrowing the vagina
How do we calculate the average length of a pregnancy?
- typically, we say that the average pregnancy lasts 280 days or 40 weeks from LMP but since fertilization usually occurs 14 days after last period, it’s about 266 days on average or 38 weeks (280-14)
What are the three stages of fetal development during pregnancy?
1) preembryonic stage: fertilization through the second week
2) embryonic stage: end of the 2nd week - 8th week
3) fetal stage: end of eight week until birth
what does the preembryonic stage begin with?
1) fertilization or conception
What is growth like during preembryonic?
cephalocaudal, proximal distal, general specific
what’s the chromosomal number of a gamete? of a zygote?
gamete = haploid, 23 zygote = diploid, 46
What is the outer layer of the ovum?
the zona pellucida, protein layer blocks other sperm once one has already entered, disappears in about 5 days
What is the sex of an XX zygote? XY?
XX: female
XY: male
what is cleavage?
just a form of mitosis, occurs in the zygote after ovum was fertilized in fallopian tubes and as it’s transported into uterine cavity
What are the autosomes?
the 22 chromosomes other than the sex chromosome
After four cleavages of the zygote, a 16 cell solid ball is formed called what? It’s the ball that reaches the uterine cavity
the morula
What develops after the morula? describe
a blastocyst: an off-center fluid-filled space appears in the morula transforming it into a hollow ball
what is the outer layer of a blastocyst that surrounds the cavity?
the trophoblast
what happens to the trophoblast as the pregnancy progresses?
it attaches to the endometrium and develops into the chorion and helps form the placenta
where does implantation usually occur in the uterus and why?
- usually in the fundus or upper uterus b/c rich blood supply and placenta can separate easier from here
What development is concurrent with the development of the trophoblast and implantation? it’s what happens to the inner cell mass of the blastocyst
- some cells become the embryo itself and others give rise to embryonic layers that surround and protect it
What are the three embryonic layers formed from the blastocyst? what does each lead to?
1) ectoderm: CNS, special senses, skin, glands
2) Mesoderm: musculoskeletal, urinary, circulatory, reproductive
3) Endoderm: resp, liver, pancreas, GI
where does fertilization take place?
ampulla of the fallopian tube
to summarize
what is the inner cell mass called and what does it form?
what is the outer cell mass called and what does it form?
inner = blastocyst, forms embryo and amnion outer = trophoblast, forms placenta and chorion
when does implantation occur?
7-10 days after conception
What should the amniotic fluid level be at term (range)?
500 mL - 2000mL
What’s the term for too little amniotic fluid at term, too much? What is each associated with
too little = oligohydramnios, uteroplacental insufficiency and fetal renal abnormalities
too much = hydramnios, maternal diabetes, neural tube defects, chromosomal deviations, and malformations of CNS and/or GI tract
What is Wharton’s jelly?
the connective tissue that surrounds the three umbilical vessels to prevent compression in cord
in a normal by the book pregnancy, does maternal and fetal blood interact?
no
What are the hormones necessary for pregnancy?
1) hCG (human chorionic gonadotropin): preserves the corpus luteum and its progesterone production so that the endometrial lining of the uterus is maintained; basis for pregnancy tests
2) human placental lactogen (hPL) or hCS (human chorionic somatomammotropin): modulates fetal maternal metab, breasts for lactation, decreases glucose use by mother so more available for fetus
3) estrogen (estriol): causes enlargement of a woman’s breasts, uterus, and external genitalia; stimulates myometrial contractility
4) progesterone (progestin): maintains endometrium, decreases uterine contractility,
5) relaxin: acts synergistically with progesterone to maintain pregnancy, causes relaxation of the pelvic ligaments, softens the cervix in preparation for birth
what is genomics?
study of all genes and includes interaction amongst genes and between genes and environment
neurofibromatosis, Huntington’s disease, achondroplasia, and polycystic kidney disease are what types of genetic disorders?
autosomal dominant
hemophilia, color blindness, and Duchenne muscular dystrophy are what type of genetic disorders?
X-linked
what is mosaicism?
chromosomal disorder not present in all cells only some of them
how many chromosomes are in the cell of someone who has a disorder with triploidy?
69 (23x3)
What is Downs syndrome caused by?
trisomy of chromosome 21
What is Trisomy 18
Edward syndrome: IUGR, hydramnios or oligohydramnios, cardiac malformatoins, single umbilical artery (all in utero); decrease in maternal levels of MSAFP and hCG
- max expextancy a year
What is trisomy 13
Patau syndrome: polydactyly, CNS issues, cleft palate
What is cri du chat syndrome?
- missing piece of chromosome 5
- distinctive cry in newborns like cat due to laryngeal defect
- microcephaly, low birth weight, wide set eyes, slow growth
what is fragile x syndrome
- also Martin-Bell syndrome
- breaks and gaps in X chromosome
- large head, hyperactivity, intellectual stuff, hand flapping, double-jointedness, autistic qualities
- most common form of male intellectual disability
Turner vs Klinefelter syndrome
Turner: bad X chromosome or missing i female, low posterior hairline, webbing of neck, short stature, broad skeleton, infertility
- growth hormones given
- usually normal intellect
Klinefelter: in males, extra x chromosome
- mild intellectual disability
- small testicles, long arms and legs, gynecomastia, scant hair, decreased libido
