Flashcards in T3-Blueprint: Abuse/Violence/Neglect Deck (28):
What is rape?
An act of power, aggression, and control
Is it okay to let the rape victim shower after their attack?
No, all labs and data need to be taken before they shower--a trained forensic nurse will do this
What does SANE stand for?
Sexual assault nurse examiner
A clinical forensic nurse who has received special training to provide care to the sexual assault victim
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
What are the 3 phases in the cycle of battering?
Phase 1: Tension-building
Phase 2: Acute or serious battering
Phase 3: Respite or honey moon phase
Phase 1: Tension-building..what happens?
Tolerance for frustration is declining; minor battering occurs (days to months)
Phase 2: Acute or serious battering..What happens?
-Batterer realized battering is deserved; battering occurs
-Victim only seeks help if injuries are severe/fear of death or harm to children
Phase 3: Respite or honey moon phase..What happens?
-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
What are some reasons the victim stays with their abuser?
-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
What is treatment for abuse?
-Individual (CBT, crisis intervention, play and art [for children], dialectical behavior, densentixation)
Nursing actions: Provide ____ when conducting interviews about family abuse
What happens in shaken baby syndrome?
-Shaking may cause intracranial hemorrhage
What do we assess for in shaken baby syndrome?
Increase in head circumference
Retinal hemorrhage may be present
What are some indicators of sexual abuse of a child?
-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)
-Reports sexual abuse by parent/caregiver
What are some things adults do that may indicate sexual abuse of a child?
-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
What are risk factors that put a child at risk for maltreatment?
-Disabilities (both physical and developmental)
-Preterm at birth
-Unwanted or unplanned
What are risk factors of the parent that may put a child at risk for maltreatment?
-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
What are envrionmental risk factors that may put a child at risk for maltreatment?
-Moms rando bf living with them
T/F: All states have mandatory reporting laws
Do we report if it is suspected?
Yes, mandatory reporting of suspected or actual cases of child or vulnerable adult abuse
What kind of questions should we ask during the history?
Open ended questions to elicit descriptive responses
Careplan for powerlessness: What is the nursing priority?
CLIENT SAFETY!!! Along with physician, ensure that all physical wounds, fractures, and burns receive immediate attention. TAKE PHOTOGRAPHS if the individual will permit
Careplan for powerlessness: After we have done client safety, where is it acceptable to do the interview? What is important about this?
Private area!! --If client is accompanied by the person who did the battering, she is not likely to be truthful about the injuries
Careplan for powerlessness. If the client has come alone or with her children, what do we need to do?
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
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)
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!!!
Care plan for powerlessness: What should we stress to the individiaul?
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