Unit 39 Sexual Assault and Domestic Violence

Question 1

What is the definition of sexual assault?

Answer 1

-Sexual act without consent which fulfills the rapist’s need to express power, degradation, anger or hostility, NOT sexual attraction

Question 2

What are the kinds of rape?

Answer 2

Date Rape: perpetrator known to the victim

Marital Rape: Sexual assault against marital partner against person’s will

Anger Rape: Characterized by excessive brutality. Offenses are unplanned and impulsive. Motives are retaliation and revenge

Power Rape: Intent of rapist is not to injure victim but to command and master another person

Statutory Rape: Women under age of consent and man older than 16 years of age

Question 3

Describe expressed response pattern, controlled response pattern, compounded rape reaction, and silent rape reaction.

Answer 3

Expressed response pattern: expresses fear, anger, crying, sobbing, smiling, tension

Controlled response pattern: Feelings are masked or hidden, and a calm, composed or subdued affect is seen

Compounded rape reaction: Additional symptoms such as depression and suicide, substance abuse, possible psychotic behaviors

Silent Rape Reaction: Victim tells no-one about attack. Anxiety is suppressed until another sexual crisis reactivates the unresolved feelings.

Question 4

What are the victim’s short term and long term effects after sexual assault?

Answer 4

Short term:

• Contusions and abrasions
• Headache, fatigue, sleep pattern disturbance
• Stomach pains, nausea and vomiting
• Vaginal discharge, rectal bleeding and pain
• Rage, humiliation, embarrassment, desire for revenge, self-blame
• Fear of physical violence and death

Long Term:

• Sense of vulnerability and loss of control
• Defiled and inability to feel clean
• Some are unable to live alone

Question 5

What are sexual assault nursing interventions for patients in the ER?

Answer 5

• Communicate patient is safe now and it is not their fault
• Ensure privacy and LIMIT caregivers
• Encourage PT to talk but do not probe
• Treat physical injuries

Question 6

What is the cycle of battery/violence?

Answer 6

Phase I: Tension building/Triggering event

Phase III: Acute battery even

Phase IV: Honeymoon phase

Question 7

What are common reactions to children witnessing violence in the home?

Answer 7

Psychosomatic complaints;

become fearful and moody;

worrying about safety;

difficulty concentrating,

trouble keeping friends;

running away;

drugs and alcohol;

and BLAMING THEMSELVES

Question 8

How does the nurse treat a battered woman?

Answer 8

• Create comfortable, supported situation
• Separate
• Focused assessment: hx of injuries, etc
• Be direct, “I always screen for DV”
• Regardless of response provide referrals
• Leaving is dangerous; develop safety plan
• Jersey Battered Women Services