T3-Blueprint: Abuse/Violence/Neglect

Question 1

What is rape?

Answer 1

An act of power, aggression, and control

Question 2

Is it okay to let the rape victim shower after their attack?

Answer 2

No, all labs and data need to be taken before they shower–a trained forensic nurse will do this

Question 3

What does SANE stand for?

Answer 3

Sexual assault nurse examiner

Question 4

A clinical forensic nurse who has received special training to provide care to the sexual assault victim

Answer 4

SANE

Question 5

A nurse that has advanced training in the collection of evidence for suspected or actual cases of sexual assault or other forms of physical abuse

Answer 5

Forensic nurse

Question 6

What are the 3 phases in the cycle of battering?

Answer 6

Phase 1: Tension-building
Phase 2: Acute or serious battering
Phase 3: Respite or honey moon phase

Question 7

Phase 1: Tension-building..what happens?

Answer 7

Tolerance for frustration is declining; minor battering occurs (days to months)

Question 8

Phase 2: Acute or serious battering..What happens?

Answer 8

• Batterer realized battering is deserved; battering occurs

- Victim only seeks help if injuries are severe/fear of death or harm to children

Question 9

Phase 3: Respite or honey moon phase..What happens?

Answer 9

• Batterer is loving and attentive and contrite
• May promise abuse won’t happen again and asks victim not to leave
• Victim wants to believe this is true and remind with hope that it is the last time

Question 10

What are some reasons the victim stays with their abuser?

Answer 10

• Hope that it will end and can have a loving relationship
• Sense of powerlessness, helplessness, and hopelessness
• Feels that the abuse is deserved
• Fear of retaliation and death of self and children
• Lack of support network encourages victim to remain
• Children: fear of losing custody
• Financial: may have no money or job skills
• Religious: Clergy counsels may try to save marriage even with evidence of abuse; they were taught that divorce is wrong no matter what; taught that if abuse occurs, it was their fault

Question 11

What is treatment for abuse?

Answer 11

• Individual (CBT, crisis intervention, play and art [for children], dialectical behavior, densentixation)
• Group/family

Question 12

Nursing actions: Provide ____ when conducting interviews about family abuse

Answer 12

Privacy

Question 13

What happens in shaken baby syndrome?

Answer 13

-Shaking may cause intracranial hemorrhage

Question 14

What do we assess for in shaken baby syndrome?

Answer 14

Resp distress
Bulging fontanelles
Increase in head circumference
Retinal hemorrhage may be present

Question 15

What are some indicators of sexual abuse of a child?

Answer 15

• Child has difficulty walking or sitting
• Suddenly refuses to change for gym or be apart of physical activity
• Reports nightmares or bedwetting
• Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
• Becomes pregnant or contracts general disease (particularly under 14)
• Runs away
• Reports sexual abuse by parent/caregiver

Question 16

What are some things adults do that may indicate sexual abuse of a child?

Answer 16

• Adult is overprotective of child, limits contact with other children..especially opposite sex
• Adult is secretive and isolated
• Adult is jealous or controlling with fam members

Question 17

What are risk factors that put a child at risk for maltreatment?

Answer 17

• Emotional/behavioral problems
• Chronic illness
• Disabilities (both physical and developmental)
• Preterm at birth
• Unwanted or unplanned

Question 18

What are risk factors of the parent that may put a child at risk for maltreatment?

Answer 18

• Parent has a low self esteem, depressed, or other mental illness
• Parent has poor impulse control
• Parent abuses drugs or alcohol
• Parent is young
• Parent was abused as child
• Parent has poor knowledge of child development and has unrealistic expectations of the child
• Parent has negative perception of normal child behaviot

Question 19

What are envrionmental risk factors that may put a child at risk for maltreatment?

Answer 19

• Social isolation
• Poverty/unemployed
• Low education
• Single parent
• Moms rando bf living with them
• Family/partner violence

Question 20

T/F: All states have mandatory reporting laws

Answer 20

True

Question 21

Do we report if it is suspected?

Answer 21

Yes, mandatory reporting of suspected or actual cases of child or vulnerable adult abuse

Question 22

What kind of questions should we ask during the history?

Answer 22

Open ended questions to elicit descriptive responses

Question 23

Careplan for powerlessness: What is the nursing priority?

Answer 23

CLIENT SAFETY!!! Along with physician, ensure that all physical wounds, fractures, and burns receive immediate attention. TAKE PHOTOGRAPHS if the individual will permit

Question 24

Careplan for powerlessness: After we have done client safety, where is it acceptable to do the interview? What is important about this?

Answer 24

Private area!! –If client is accompanied by the person who did the battering, she is not likely to be truthful about the injuries

Question 25

Careplan for powerlessness. If the client has come alone or with her children, what do we need to do?

Answer 25

Assure her of her safety!

• Encourage her to discuss that battering incident
• Ask questions about if this has happened before or if abuser takes drugs
• Do you have a safe place to go?
• Are you interested in pressing charges?

Remember: some women will attempt to keep secret how their injuries occur in an effort to protect the partner of bc they are fearful that the partner will kill them if they tell

Question 26

Careplan for powerlessness: What does it mean by this intervention below

We need to ensure that “rescue” efforts are not attempted by us (the nurse)

Answer 26

We need to offer support, but the final decision must be made by the client—-the client making her own decision will give the client a sense of control over HER life situation

Imposing judgments and giving advice is nonthreapeutic!!!

Question 27

Care plan for powerlessness: What should we stress to the individiaul?

Answer 27

The importance of safety

-Tell her about resources (crisis hotlines, community groups from women who have been abused, shelters, counseling services, victims rights in civil and criminal justice system)–> Folowing this discussion, let the client choose FOR HERSELF!!! *if her decision is to return to the marriage and home, this must be RESPECTED

Question 28

Care plan for powerlessness: What does knowledge of available choice decrease in the victim?

Answer 28

Decreases the individuals since of powerless, but true empowerment comes only when she chooses to use that knowledge for her own benefit