Family Violence/Human Trafficking (Exam 3)

Question 1

Violence and trafficking demographics

Answer 1

• 1 in 4 women (more than 20%)/1 in 10 men (14%) are victims of intimate partner violence (IPV) 10 MIL PEOPLE
• more than 19,000 calls are made to IPV hotlines a day
• 1 in 7 children experience abuse/neglect, 5 children dying each day (656,000 a year) required by law to report
• 1 in 10 people older than 60 go through elder abuse a day (underreported, MUST REPORT, most commonly adult child or spouse)

Question 2

Physical violence

Answer 2

use of force that could cause death, disability, injury

Question 3

Sexual violence

Answer 3

any attempted or completed sex acts without consent

rape, unwanted sexual contact, exposure to sexual situations

Question 4

Stalking

Answer 4

repeated, unwanted attention that leads to fear (repeated phone calls, spying, damaging personal property)

Question 5

Psychological Aggression

Answer 5

form of emotional abuse wherein the aggressor uses verbal/nonverbal communication to exert control or harm person emotionally

Question 6

Neglect

Answer 6

failure to provide for a child’s basic needs

prenatal drug exposure, child abandonment, manufacturing of meth in presence of child

Question 7

Emotional abuse

Answer 7

any pattern of behavior that harms a child’s emotional development or sense of self worth

frequent belittling, rejection, threats, withholding love and support

Question 8

Neglect (Elder abuse)

Answer 8

failure of the caregiver to prevent harm

failure to meet basic needs like hygiene, nutrition/hydration, clothing, shelter and medical care

ELDER ABUSE SUSPICION INDEX (EASI)

Question 9

Financial elder abuse/exploitation

Answer 9

unauthorized/improper use of elders resources for monetary or personal benefit, profit, gain

forgery, theft, improper use of guardianship or power of attorney

Question 10

Human trafficking demographics

Answer 10

more than 40 people worldwide (labor, forced marriages)
mostly women and girls (71%)
25% are children

Question 11

Documentation for suspected abuse

Answer 11

• detailed, nonbiased progress notes, injury maps, and photos
• phrases that identify the reported perpetrator and severe threats of harm are important
• quote/paraphrase history exactly as patient describes
• separate from suspected abuser during interview
• prior written consent to take photos should be obtained from all cognitively intact adults

Question 12

Abrasion

Answer 12

a wound caused by rubbing the skin or mucous membrane

Question 13

Avulsion

Answer 13

tearing away of a structure or part

Question 14

Bruise

Answer 14

superficial discoloration caused by hemorrhage into the tissues from ruptured blood vessels beneath the skin surface, without the skin itself being broken (contusion)

Question 15

Contusion

Answer 15

a bruise; injury to tissues without the breakage of skin; blood from broken blood vessels accumulate, producing pain, swelling, tenderness

Question 16

Ecchymosis

Answer 16

a hemorrhagic spot or blotch, larger than petechia, in the skin or mucous membrane, forming a non elevated rounded or irregular blue or purplish patch

Question 17

Hematoma

Answer 17

a localized collection of extravasated blood, usually clotted in an organ, space or tissue

Question 18

Incision

Answer 18

a cut or wound made by a sharp instrument, the act of cutting

Question 19

Laceration

Answer 19

the act of tearing or splitting; a wound produced by the tearing or splitting of body tissue, usually from blunt impact over a bony surface

Question 20

Lesion

Answer 20

a broad term referring to any pathologic or traumatic discontinuity of tissue or loss of function of a part

Question 21

Patterned injury

Answer 21

an injury caused by an object that leaves a distinct pattern on the skin/organ (being whipped with an extension cord) or an injury caused by a unique mechanism of injury (immersion burns to the hands or feet (glove or sock))

Question 22

Pattern of injuries

Answer 22

usually bruises and fractures in various stages of healing

Question 23

Petechiae

Answer 23

minute, pinpoint, nonraised, perfectly round purplish red spots caused by intradermal or submucous hemorrhage, which later turn blue or yellow

Question 24

Stab wound

Answer 24

a penetrating, sharp, cutting injury that is deeper than it is wide

Question 25

Traumatic alopecia

Answer 25

loss of hair from pulling and yanking by other traumatic means

Question 26

Wound

Answer 26

a general term referring to a bodily injury caused by physical means

Question 27

Subjective Data

Answer 27

• know tools in facility so you can screen for abuse
• “tell me what happened”
• listen for cues of abuse like explanations that don’t match injury or inability to keep story straight
• frequently seeking care for injuries is another potential indicator

Question 28

IPV

Answer 28

“do you feel safe at home?”

Hurt, Insult, Threaten, Scream (HITS)

Question 29

Child abuse/neglect screening

Answer 29

subjective data will come from caregiver, BE ATTENTIVE TO INTERACTION BETWEEN CAREGIVER AND CHILD

history should be obtained away from caregiver through open ended questions

Question 30

Human trafficking screening

Answer 30

no standard tool

HEAL Protocol14
Adult Human Trafficking Screening Tool and Guide

Question 31

Objective Data: Bruising

Answer 31

document size, color, pattern of bruises
do not try to determine timing of injury
do not guess what created bruise
objectively describe findings in EMR

Question 32

Suspected elder abuse victims should be screened for…

Answer 32

• complete blood count (CBC) with platelet level
• basic blood chemistries (blood urea nitrogen (BUN), creatinine, protein, albumin)
• serum liver function tests
• coagulation panel
• urinalysis

Question 33

Suspected sexual abuse/human trafficking victims should be screened for…

Answer 33

STIs
pregnancy

Question 34

Burn injuries

Answer 34

immersion
pattern
cigarette

Question 35

Suspicious bruising

Answer 35

fingers
belt and buckle
nasal fracture
thigh bruises
defensive wounds