Week 10: Assessing for Violence and Intimate Partner Violence

Question 1

Interpersonal violence (IPV)

Answer 1

Any incidence of threatening behavior, violence, or abuse between individuals who are or have been intimate partners/family members, regardless of gender or sexuality

Question 2

Violence

Answer 2

Types of violence:
1. PHYSICAL: Any intentional act causing injury or trauma to another person by way of bodily contact

2. PSYCHOLOGICAL/EMOTIONAL: Subjecting or exposing another person to behavior that may result in psychological trauma
3. ECONOMIC: Controlling a victim’s ability to acquire, use, and maintain financial resources
4. SEXUAL: Abusive sexual behavior by one person upon another; it is often perpetrated by force or by taking advantage of another

Question 3

Theories

Answer 3

IPV theories:
1. PSYCHOPATHOLOGY – trauma during childhood is believed to influence the development of similar behaviors when adult; contributes to mental disorders (i.e. Depression, PTSD)

2. SOCIAL LEARNING/FAMILY SYSTEMS – being raised in a family culture where abuse towards one another is perceived as a norm; it is then carried out within their own lives
3. BIOLOGIC – substance abuse, poverty, and early neglect in an individual

Question 4

Red flags: Health history

Answer 4

**Create an environment that is safe, comfortable, and confidential; ask simple questions and speak in a calm manner

Red flags – Subjective data:
1. History is inconsistent with PE

2. Conflicting accounts from pt and their caregiver
3. Failure of response to usual therapy
4. Frequent use of the ER, or multiple clinics/hospitals
5. Delay in presentation for treatment
6. Pt is not allowed to speak for themselves, even if capable
7. A history of alcohol or drug abuse in the elder or their caretaker

Question 5

Red flags: Physical assessment

Answer 5

Red flags – Objective data:
1. Bruises, black eyes, welts, lacerations, and rope marks

2. Broken bones, open wounds, cuts, punctures, and untreated injuries in various stages of healing
3. Broken eyeglasses/frames, or any physical signs of being punished or restrained
4. Sudden change in behavior
5. Bruises around the breasts or genital area
6. Unexplained venereal disease, genital infections, or vaginal or anal bleeding
7. Torn, stained, or bloody underclothing
8. Being emotionally upset or agitated, withdrawn and non-communicative, non-responsive, or nervousness around certain people
9. Dehydration, malnutrition, untreated bed sores and poor personal hygiene
10. Untreated health problems
11. Inappropriate clothing, lack of necessary medical aid, or not taking prescribed meds. properly

Question 6

Mandatory reporting

Answer 6

Vulnerable adults: An adult who lacks the physical or mental capacity to provide for their daily needs

Report all child abuse – abuse committed by a parent, guardian, or other person with permanent or temporary care or custody

Child abuse reports are confidential; ANYONE who suspects physical or sexual abuse of a child (up to 18 yrs. old) is required to report to CPS

Question 7

Forensic nurse examiner

Answer 7

Role of FNE:
1. Advocate for the patient

2. Treat wounds and provide prophylactic medications
3. Evidence collection – thorough PE and detailed documentation of exam findings
4. Collaborate with law enforcement – provide all necessary resources and testify on pt’s behalf as an expert witness when needed

Question 8

Safety plan

Answer 8

Include:
1. Cash and jewelry

2. Important documentation – DL, birth certificates, marriage license, copy of protection order, SSNs, bank account numbers, and insurance polices and account numbers
3. Phone numbers

**Inquire: Packed bag hidden and ready to go? Code word? Where will they go when they leave? Weapons removed?