crisis, aggression, violence, abuse (ch 26, 27, 28, 29) Flashcards
TEN 4 FACES P assessment
Trunk
Ears
Neck
4 years or younger, any bruising on child <4 months
Frenulum (in mouth) Auricular area Cheek Eyes (bloodshot) Sclera
Patterned bruising
type of violence: form of injury, no medical care
physical
type of violence: sexual contact without consent
sexual
type of violence: undermines self esteem
emotional
type of violence: control over finances
economic
type of violence: intimidation by isolation
psychological
type of violence: not providing basic care
neglect
S+S physical abuse in children (5)
- flinching when touched
- injuries at various stages of healing
- bruising on forearms
- high pain tolerance
- inconsistent improbably explanations
S+S sexual abuse in children (7)
- frequent UTIs
- rectal bruising/fissures
- STDs
- sexual knowledge beyond age
- promiscuity
- fear/avoidance of particular family member
- excessive masturbation
tips with working for abused children
- interview separately
- mandatory reporting
- avoid calling parents “bad”
- don’t recreate abusive scenarios
- understand symptoms
- consistent, clear team approach
syndrome: child abuse in which caregiver persistently lies about symptoms of child or actually induces them with intent of meeting emotional needs of parent
munchausen syndrome by proxy
phases of domestic abuse (6)
-honeymoon phase
-build up phase
-stand over phase
-explosion
-remorse phase
-pursuit phase
REPEATS
characteristics of batterers (ABCDEFGH)
Abused as children Believe in traditional sex roles Controlling Deny, minimize, blame Emotionally abusive Feelings of low self esteem Grew up being violent Hyde and Jekyll
warning signs of a batterer
- jealousy
- controlling behavior
- hypersensitivity
- volatility
- cruelty to animals
- hostile language
- isolating
- breaking objects
- threatening violence
reasons women stay in abusive relationships (5)
- abuser will change
- no place to go
- fear of losing finances
- higher loyalties, “put up with”
- fear of worse violence
HITS assessment
Hurt you physically
Insult or talk down to you
Threaten you with harm
Scream or curse at you
directions for someone who is raped (5)
- go to safe place
- don’t shower, wash hands, clothes, brush teeth
- get medical attention
- police report
- write down details
comorbid disorders with rape/domestic violence (5)
- depression
- PTSD
- anxiety
- substance abuse
- sleep disorders
most important predictor imminent violence
hyperactivity
interventions for pts with delirium
- find and treat medical cause
- low dose antipsychotic
- decrease stimuli
highest number of childhood abuse and fatalities by race
african american
RF for abuse in older adults (5)
- female
- 75+ yo
- white
- living with relative
- physical and/or mental impairment
secondary prevention of abuse
- early intervention in abusive situations
- screening programs
primary prevention of abuse
- reducing stress
- reducing influence of RF
- increasing social support
- increasing coping skills
- increasing self esteem
