Final - Abuse & Violence Flashcards
1
Q
What is multigenerational transmission of violence?
A
- Violence perpetuated through generations by a cycle of violence.
- Child learns abusive behaviors through experiences with parents/other adults & come to believe violence to be way of solving problems (becomes automatic).
2
Q
Describe the correlation between alcohol and drug abuse & violence
A
- Survivors of violence often report substance abuse by the abuser
- Use of alcohol/drugs may increase violent behavior by reducing fear or inhibitions
- Crack cocaine, amphetamines, mescaline, “angel dust” (PCP) and steriods associated with increased violence
- “Date-rape drugs” e.g. flunitrazepam (Rohypnol), place people, primarily young women, in danger of sexual exploitation, physical harm
3
Q
What are Implications of Abuse & Violence for Survivors?
A
- Physical injury and death; developmental issues.
- A whole range of psychiatric & emotional problems:
- fear; anger; anxiety; depression; flashbacks; suicidal ideation; sleep disturbances; appetite & eating problems; drug use & abuse; somatic complaints; school & work issues–truancy, poor performance & drop out, etc.
- More likely to develop PTSD –> especially with rape
- Depression
- Belemia
- Potential to develop into any of the major mood, anxiety & other disorders previously discussed.
4
Q
What are some nursing attitudes towards survivors?
A
- Paternalistic – knows what is good for the survivor & advises on what to do, while sympathizing.
- Empowering – recognizes & respects the competencies of the survivors & empathisizes & strategizes with them.
- Blaming – projects blame due to failure to properly explore own attitudes & isolate personal biases.
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5
Q
What are preventive interventions for violence?
A
- Primary prevention—changing society’s acceptance of violence & abuse
- Secondary prevention—identifying families at risk
- Tertiary prevention—addressing immediate & long-term needs of survivors of abuse
6
Q
What are some barries to identification of abusive relationships from the patient’s perspective?
(Can be dependent personality disorders)
A
- “Denial” of person being abused
- Shame, embarrassment, or cultural beliefs
- Past negative experiences with family members & health care providers
- Intrapersonal & relationship dynamics that hold perpetrator & victim together
7
Q
What are some barries to identification of abusive relationships from the provider’s perspective (Ex: The nurse)?
A
- Avoidance of delving into topic of potential abuse
- Fear of “offending” clients
- Holding false stereotypes regarding abusive behavior
- Feeling powerless to address the problem
- Lack of awareness of local resources
8
Q
What are some possible indicators of child sexual abuse?
A
- Sexual acting out, physical aggression, excessive masturbation, social withdrawal, expressions of low self-esteem, impaired school performance, disturbed sleep
- Recurrent urinary tract infections, sexually transmitted infections, unintended pregnancy
- Bleeding, soreness, or itching in or around genitals, perineum, or rectal area
- Chronic pain syndromes
- Has difficulty walking or standing
- Suddenly refuses to change for gym or to participate in physical activities
- Reports nightmares of bedwetting
- Experiences sudden change in appetite
- Runs away
9
Q
What are some nursing interventions for child abuse?
A
- When child abuse suspected, nurse must report it to protective services
- Investigation by state protective service agency legally mandated
- Reinforces to family the seriousness of the problem
- Explain to family what will happen in investigation, amount of time involved
10
Q
What is intimate partner violence?
A
- Pattern of assaultive and coercive behaviors, including physical, sexual, and psychological abuse and violence, used against intimate partners
- Behavior to achieve compliance from or control over target person
- May include dating, married, or cohabitating relationships, heterosexuals, homosexuals
11
Q
What are the different cycles of battering?
A
- The Tension-Building Phase –> person might be on edge
- The Acute Battering Incident –> most violence, shorter period, often the batter minimizes the incident, blams the other person, victim most likely to leave in this phase
- Calm, Loving, Respite (“Honeymoon”) Phase –> occurs when person trying to get forgiveness, person thinks everything will be okay, vicims might feel dependent, powerless, hoplessness,
- When the person leaves for good that is the highest chance for homicide
12
Q
Describe the nursing assesment for intimate partner violence
A
- Ask about quality of primary intimate partner relationship
- ¡Feelings of being controlled or needing to control?
- ¡Excessive jealousy?
- ¡How do you solve conflicts?
- ¡Do arguments ever involve pushing or shoving?
- Start with questions about minor domestic violence
- Patient who hesitates, looks away, displays discomfort with the subject can be asked about physical violence later in interview
13
Q
What are some nursing inverventions for intimate partner violence?
A
- Tell survivors they are not alone
- Tell them they are not to blame
- Confidentiality counts
- Document situation thoroughly
- Educate about legal aspects, available community resources
- Safety, especially if planning to leave relationship – ensure there is a safety plan
14
Q
What are the treatment options for intimate partner violence?
A
- Combines behavioral therapy centered on anger control
- Traditional marriage therapy or couple counseling as only treatment in potentially dangerous to survivor
- ¡Unequal power in relationship
- ¡Possibility of retaliatory violence
15
Q
Describe elder abuse
A
- Older adults primarily abused, neglected, or exploited by caregivers, mostly spouses, adult children, or other family members
- Personal care attendants may perpetrate elder abuse, neglect, exploitation
- Socially isolated, cognitively impaired, or those dependent on others for daily personal needs seem most vulnerable to abuse and neglect
16
Q
What would you assess for when looking for possible elder abuse?
A
- Physical assessment and careful attention to nonverbal behavior critical
- May have bruises to upper arms from shaking
- Regard abrasions and lacerations not usually caused by falls, especially to face or torso , with suspicion
- Vaginal lacerations or bruises and twisting bone fractures particularly indicate abuse
17
Q
What are some signs of elder neglect?
A
- Signs of neglect more common than those of physical abuse
- Neglect may be manifested by poor hygiene, skin breakdown, malnutrition, dehydration, underdosing or overdosing of prescriptive medications
- Determine if neglect is intentional
18
Q
What are some nursing interventions for elder abuse?
A
- Most states have mandatory reporting of abuse or neglect of elderly
- Respite care or other stress relievers may be key interventions for overburdened caretaker
- In other cases, primary intervention may be therapeutic assistance for abusers
- ¡May include counseling, therapy for mental disorders, substance abuse treatment
19
Q
What is sexual assault?
A
- Forced penetration or act of sexual contact with another person without consent
- Lack of consent could relate to survivor’s cognitive or personality development, feelings of fear or coercion, or offender’s physical or verbal threats
- Sexual assault is not a sexual act but is instead motivated by desire to humiliate, defile, dominate the survivor
20
Q
What is marital rape?
A
- Legally recognized in most states, often reported long with physical abuse
- Many husbands of abused women believe it is their right to have sex whenever they want
- Survivors of marital rape described forced vaginal intercourse; anal intercourse; being hit, burned, or kicked during sex, having objects inserted into their body and threatened or beaten if they refuse
21
Q
What are some nursing interventions for patients who have been sexually assulted?
A
- Provide nonjudgmental listening/support
- If recent assault disclosed, need physical evidence if survivor chooses to take legal action against perpetrator
- Evidence collection requires special training by a sexual assault nurse examiners (SANE)
- Later interventions may include referrals to survivor’s groups, shelters for battered women, legal services
- Coping strategies: changing one’s phone number or residence; talking with friends or family, taking classes in self-defense
- Nursing actions to help survivor of sexual assualt: active listening, empathetic responses, active concern and caring, assistance in problem solving, referral to sexual assault crisis centers
22
Q
What are the 2 stages of sexual assault?
A
- Acute stage: immediately after attack
- Second phase: long-term process of reorganizaiton
23
Q
What are some nursing interventions for sexual assult?
A
