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Mental Health > WEEK 4: Abuse > Flashcards

WEEK 4: Abuse Flashcards

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1
Q

Abuse involves systematic strategies used to obtain dominance and control over others and can be displayed in a variety of ways, such as

A

psychological, physical, emotional, economic, and sexual.

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2
Q

Individuals who have experienced abuse are at higher risk for developing

A

substance use disorders, anxiety disorders, depressive disorders, eating disorders, borderline personality disorder (BPD), and posttraumatic stress disorder (PTSD).

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3
Q

define physical abuse

A

The intentional inflection of bodily harm or pain on others.

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4
Q

how would perpetrators of physical abuse harm

A

kicking
hitting
slapping
pushing
strangling
or biting

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5
Q

Potential Signs of Physical Abuse: body findings

A

bruising, lacerations, burn marks, fractured bones, puncture wounds, wounds in various stages of healing

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6
Q

Potential Signs of Physical Abuse: general appearance

A

ripped or torn clothing, broken eyewear, disheveled hair and clothing

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7
Q

define emotional abuse

A

The intentional infliction of mental anguish through means of intimidation and humiliation.

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8
Q

Potential Signs of Emotional Abuse/Mental Mistreatment

A

Changes in usual behavior, such as social withdrawal or non-responsive communication
Loss of self-esteem
Anxiety provoked by the presence of certain people
Client’s report ​​​​​​​of enduring verbal or mental mistreatment

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9
Q

define sexual abuse

A

Any forced, inappropriate, or unwanted sexual contact and actual or threatened sexual violence

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10
Q

examples of sexual abuse/violence

A

photographs that are sexually explicit, indecent exposure, unwanted touching, rape, forcing individuals to engage in sexual acts, or coerced nudity

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11
Q

luring

A

Use of internet technology to enable the sexual abuse of others.

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12
Q

Potential Signs of Sexual Abuse

A

Sudden changes in behavior such as fear of people or places
Sexually explicit behavior or sex play
Regression to younger behaviors such as bedwetting
Developmentally inappropriate interest in human sexuality
Discomfort, bruising, or bleeding around the breasts, anus, or genital area
Unexplained or recurring sexually transmitted infections (STIs)
Underclothing that is damaged or contains bloodstains
Client’s report of being sexually assaulted

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13
Q

define neglect

A

The failure of a caregiver to provide needed food, clothing, shelter, medical care, or supervision to the degree that the child’s health, safety, and well-being are threatened with harm.

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14
Q

define abandonment

A

When an individual has been left in circumstances in which they suffer serious harm, a caregiver’s identity or whereabouts are unknown, or the caregiver has failed to maintain contact or provide reasonable support for a specified period of time.

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15
Q

Potential Signs of Neglect or Abandonment

A

Unattended or untreated health problems
Dehydration, malnutrition, untreated pressure injuries, and poor personal hygiene
Hazardous living conditions (improper electrical work, no running water or heat)
Poor living conditions (visible dirt, insect infestation, soiled bedding, fecal/urine smell, insufficient clothing)
Desertion of a vulnerable individual
Client’s report of being abandoned or mistreated

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16
Q

economic abuse/exploitation define

A

Misuse of another person’s financial resources, with or without permission

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17
Q

examples of economic abuse/exploitation

A

stealing, forging checks, promising to pay bills for a person but keeping the money for themselves, and falsifying wills or financial records

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18
Q

Potential Signs of Exploitation/Economic Abuse

A

Sudden banking and accounting changes (unexplained withdrawals, transfers, or the addition of unauthorized names onto accounts)
Abrupt changes in availability of funds, possessions, wills, or other financial documents
Individual does not remember signing financial records
Client’s report of exploitation

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19
Q

Which of the following forms of abuse should the charge nurse identify as being the hardest to identify?

A

emotional

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20
Q

why is emotional abuse harder to detect

A

because no physical evidence is apparent

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21
Q

aggression vs. anger

A

aggression is ACTIONS intended to harm someone

anger is an EMOTION that can be positive or negative

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22
Q

how can anger be positive

A

when its controlled, it can lead to evoke positive changed

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23
Q

what can happen from negative anger

A

hypertension, headaches, insomnia, and digestive issues, and potentiates the possibility of harm to self and others

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24
Q

how can anger be displayed

A

cursing, sarcasm, yelling, breaking an inanimate object, or making a fist, but is not often followed by an aggressive act

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25
Individuals who have demonstrated aggressive behaviors, and those who have been diagnosed with schizophrenia, autism spectrum disorder (ASD), or attention-deficit/hyperactivity (ADHD), are found to have higher serum levels of
serotonin subtype 5-hydroxytryptamine (5-HT)
26
Individuals who have the following disorders are more prone to acting out violently
Substance use disorder Traumatic brain injuries (TBI) PTSD Bipolar I disorder Impulse control disorders Attention deficit hyperactivity disorder (ADHD)
27
Examples of ACES include the following.
Experiencing violence, abuse, or neglect Family member attempted or died by suicide Observing violence in the home Unsafe or unstable home environment (substance misuse, mental illness, parental or sibling separation)
28
Examples of questions asked to determine ACEs, prior to the age of 18
Were you made to feel afraid by an adult in your household? Were you injured by an adult in the household? Were you touched in a sexual manner by anyone in the home that was at least 5 years older?
29
Abuse, aggression, and violence can be accompanied by comorbidities such as
schizophrenia, psychosis, anxiety disorders, substance use disorders, bipolar disorder with mania, major depressive disorder (MDD), attention-deficit/hyperactivity disorder (ADHD), posttraumatic stress disorder (PTSD), conduct disorders, and personality disorders
30
Risk Factors Associated with Abuse, Aggression, and Violence
History of violence Being the victim of a crime Witnessing abuse or violence Poor self-esteem and inadequate coping skills No presence of positive role models throughout childhood Adverse childhood experiences
31
Research has demonstrated a link between deficient variations of the MAO-A gene and aggressive behavior, including an increase in
5-HT levels
32
MAO-A gene
This abnormal gene was originally found in several families. The condition associated with this abnormal gene is called Brunner syndrome, a rare genetic condition that is characterized by impulsivity, aggression, mild cognitive impairment, and violence.
33
Clients experiencing unwelcomed thoughts that may trigger abusive actions, aggression, or violence have been known to employ the following defense mechanisms:
displacement and undoing
34
displacement
Redirecting troublesome or difficult thoughts to a safer person, animal, or inanimate object.
35
undoing
When an individual performs a behavior in an attempt to resolve unwanted thoughts or feelings associated with a previously completed behavior. aka trying to "undo" the wrong by making it up with doing a nice or good thing
36
An example of undoing
when a client emotionally abuses their partner in front of others but the next day buys them the new piece of clothing they wanted
37
example of displacement
abuser being angry at coworker but taking it out on their child or partner as an alternative
38
The following behaviors are often seen in clients prior to violent or aggressive actions
Declining to eat or drink Attempting to leave the area before discharge Verbally antagonistic toward staff or visitors Harming self Staring Pacing Destroying inanimate objects
39
A nurse is providing care to a client who has acknowledged they have become violent with family members when “they just don’t listen!” Which of the following warning signs should the nurse recognize often precede violence? (Select all that apply.)
Rips multiple pages out of a novel (destroying inanimate object) Refuses breakfast and afternoon snack (declining food or drinks) Pacing Attempting to leave area before discharge
40
cycle of violence
for IPV and other forms of violence phase 1: build up phase 2: acute phase 3: honeymoon/reconciliation
41
Strategies to Help Prevent Intimate Partner Violence (IPV)
Teach skills needed for healthy relationships to both youth and adults Empower peers to provide preventive strategies Provide early intervention and education to at-risk families/individuals Help create safer environments (school, workplace) Reinforce economic stability Intensify support to survivors
42
Approaches used by stalkers include the following
Following and watching their target Obtaining entry into target’s car or house and leaving items to let them know they can enter at anytime Showing up unannounced at target’s home, workplace, or school Nuisance phone calls, emails, text messages, etc.
43
Bullying, considered an adverse childhood experience (ACE), is defined
as uninvited behaviors from one youth or group of youths to another that are aggressive in nature.
44
forms of bullying include the following
Kicking, hitting, tripping Teasing and name-calling Excluding targets from group or spreading rumors Destruction of property belonging to target
45
Strategies to Prevent Cyberbullying From Occurring
Paying attention to what is posted online and knowing who can see it Keep caregivers aware of online activities Tell an adult if you get a message that frightens you Keep your passwords secret from peers and friends but inform caregivers Always be kind online
46
Survivors of abuse/violence may...
Deny anything happened. Be fearful of what will happen to them once they leave the facility. Be wary of health care professionals. Demonstrate a lack of concern about their own needs. Be sleep deprived or malnourished.
47
approach to interview survivors of violence and abuse
allow the survivor to have control of where they want to sit, take breaks, etc do not touch survivor without permission! remember that they may be wary of being open
48
what is the best way for nurses to avoid self-bias
reflect on their own personal beliefs
49
pharmacological interventions for long-term control of aggression
antipsychotics (benzodiazepines, mood stabilizers, anticonvulsants, and antidepressants)
50
For clients who have been physically restrained, administration of sedating medications, such as
lorazepam or haloperidol, is common.
51
active shooter model to safety
run hide fight
52
nursing process: recognizing cues of aggression
​​​​​​​Restlessness and pacing Increased agitation with verbal or physical threats to self or others Impaired thoughts
53
nursing process: planning for aggression
pharm interventions de-escalation restraint or seclusion
54
Define Nonsuicidal self-harm (NSSH)
intentional harming of self and involves such acts as cutting (most prevalent), scratching, biting, carving words or designs into skin, burning, hair pulling, headbanging, and any other self-inflicted destruction of body tissue
55
what age group is NSSH most often seen in
adolescents
56
While the intent of NSSH is not death, evidence suggests that clients using self-harm as a
coping mechanism are at risk of becoming dependent upon their actions and normalizing NSSH into long-term coping strategies, potentially leading to more serious injuries, including suicide
57
long-term effects of NSSH
Infections Scarring Excessive bleeding Shame and guilt Reduced sense of self Social isolation
58
Possible warning signs of NSSH
Unexplained scars Fresh cuts, burns, scratches, or bruises that cannot be explained Excessive rubbing of skin that leads to a burn Keeping sharp objects available but hidden Keeping arms and legs covered despite weather conditions Poor interpersonal relationships Personal identity issues Unpredictable and impulsive emotions/behavior Feelings of worthlessness, helplessness, and/or hopelessness
59
nursing interventions of NSSH
Early recognition Available and affordable treatment resources Educational and supportive services
60
Therapeutic Questions to Ask Someone Experiencing NSSH
What prompted you to do this? What happened prior to this? What do you feel when you do this?
61
is NSSH seen more in females or males
females
62
role the neurological system plays in relation to aggression
Excessive amygdala reaction and inadequate regulation of the prefrontal area will increase the likelihood on aggression in the client
63
hostile aggression examples
aka examples of aggression hitting someone when you get mad
64
what neurotransmitter plays a significant role in aggression
excess of serotonin
65
role of a forensic nurse
provide legal testimony as requested by the client
66
warning sign examples of NSSH
wearing a long-sleeve shirt in summer time (to hide cuts or other injuries)
67
chlopromazine
an IM injection use for a client acutely becoming aggressive
68
at what stage of the cycle of violence would the abuser become affectionate towards the victim
respite aka phase 3: honeymoon phase
69
mental health history that can lead someone to being aggressive or violent
schizophrenia autism TBI sexual abuse victim bipolar disorder
70
medication: caring for a client who is demonstrating aggressive behavior towards others and is not responding to verbal interventions.
Ziprasidone
71
vital signs with anxiety
increased HR and BP, which can escalate to physical violence
72
Brunner syndrome
rare disorder from MAOA gene characterized by impulsivity, aggression, mild cognitive impairment, and violence
73
therapeutic principles for the use of seclusion
containment, isolation, and decrease in sensory input
74
reason why individuals engage in self-harm
express emotions that may be embarrassing to show
75
define ACEs
a traumatic event that a child experiences before the age of 18

Mental Health (4 decks)

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