Domestic and Child Abuse Awareness

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Questions and Answers

What should not be documented in the chart until law enforcement arrives on the scene?

The victim’s injuries and their patterns

Details of the patient’s history with the abuser

That law enforcement has been contacted (correct)

The victim’s feelings about their relationship

In which phase does a victim often experience hope for change alongside the abuser's attempts for forgiveness?

Escalation phase

Post-abuse phase

Honeymoon phase (correct)

Crisis phase

Which type of injury is specifically highlighted as a consequence of physical abuse?

Traumatic brain injury (correct)

Fractured bones

Soft tissue injuries

Burns and contusions

What approach should be taken when initially assessing a victim of abuse?

Start with broad questions about their home life Signup and view all the answers

What is emphasized regarding communication when children are present during an intervention?

Avoid negative comments about the abuser Signup and view all the answers

What is a primary responsibility of the nurse when dealing with a patient who may have experienced a crime?

Report the incident to law enforcement regardless of the patient's wishes Signup and view all the answers

Why is thorough documentation important in nursing care for victims of assault?

It serves as legal evidence and ensures accurate reporting Signup and view all the answers

What should a nurse do if they encounter a patient who needs immediate assistance but is in a potentially harmful environment?

Remain near an exit and ensure personal safety while providing care Signup and view all the answers

How should a nurse evaluate the effectiveness of their interventions for a patient who has been a victim of violence?

By asking questions about the patient's goals, self-esteem, and resources Signup and view all the answers

What type of nurse should be contacted when evidence collection is needed in a case of assault?

A forensic nurse specializing in evidence collection Signup and view all the answers

What is a common physical sign of child abuse?

Cigarette burns Signup and view all the answers

Which behavior is most concerning in a 7-year-old regarding sexual interest?

Exhibiting unusual sexual interest Signup and view all the answers

What is a characteristic emotional response observed in elderly abuse victims?

Avoiding eye contact Signup and view all the answers

In the context of sexual assault, how is statutory rape defined?

When a victim is a minor, regardless of consent Signup and view all the answers

What phase typically occurs days to weeks following an initial traumatic event?

Acute phase Signup and view all the answers

Which of the following is a behavior often associated with shaken baby syndrome?

Nausea and irritability Signup and view all the answers

What term is used for a situation where a caregiver fabricates or induces illness in a child?

Medical child abuse Signup and view all the answers

Which statement best describes the Outward Phase of trauma recovery?

A long period of recognizing therapy as necessary begins. Signup and view all the answers

What is a risk factor for developing PTSD following abuse?

Difficulties in interpersonal relationships Signup and view all the answers

What is an appropriate action when collecting evidence from a sexual assault victim?

Ensure to wear gloves during collection Signup and view all the answers

Which of the following behaviors may indicate the presence of elder abuse?

Assuming a fetal position and showing depression Signup and view all the answers

Which of the following is a recommended nursing diagnosis for a patient who has experienced trauma?

Risk for suicide or self-abuse Signup and view all the answers

In trauma-informed care, which step emphasizes the need to understand recovery paths?

Realize Signup and view all the answers

What is crucial for ensuring the safety of an abuse survivor during the assessment?

Providing a private and secure space for discussion Signup and view all the answers

Study Notes

Domestic Violence

Documenting law enforcement contact should only occur when law enforcement is already on-site.
Victims may hide their abuse during this phase.
The "honeymoon phase" is characterized by the abuser begging for forgiveness and displaying loving behavior.
Physical abuse injuries may show patterns like those from a belt or iron.
Traumatic brain injury (TBI) is a common consequence of physical abuse.
Chronic traumatic encephalopathy is a type of TBI often caused by repeated head trauma from abuse.
Short-term interventions include assessing for immediate danger and assuring the victim they are not to blame.
Avoid negative comments about the abuser in the presence of children.
Ensure the patient has a safe discharge plan.
Start with broad questions about their home life and relationship, then transition to more direct inquiries about potential abuse.

Child Abuse

Abusers often expect children to fulfill their needs and may exhibit poor impulse control.
Physical signs of abuse in children include cigarette burns, water burns, sprains, and fractures.
Shaken baby syndrome can cause bruising, swelling, or bleeding in the brain, which is a type of TBI.
Signs of shaken baby syndrome include irritability, poor feeding, convulsions, and pale or blue skin.
Sexual abuse in children may manifest as bedwetting, nightmares, STIs, and hyperactive gag reflux.
Father-daughter incest often involves the oldest daughter and the mother may be aware of it.
Medical child abuse is often associated with Munchausen syndrome by proxy, now referred to as factitious disorder.
Unusual sexual interest in young children is concerning and should be addressed.
Running away from home can be a strong indicator of sexual abuse.

Elder Abuse

Indicators of elder abuse include the abuser avoiding eye contact with the victim, the victim assuming a fetal position, and signs of depression.
Unusual financial activity or concern about financial issues related to the victim's health can signal abuse.

Sexual Assault

Rape is an act of aggression, not passion.
Stranger rape is a random event where the perpetrator chooses a stranger as the victim.
Acquaintance rape, also known as date rape, is often unreported.
Marital rape is the rape of a married individual by their partner.
Statutory rape involves a victim who is a minor, even if they consent, it is still considered rape.
In North Carolina, the legal age of consent is 16.
Heightened responses to sexual assault include hypervigilance and difficulty concentrating.

Phases of Healing from Sexual Assault

Acute Phase (Days to Weeks): Characterized by hypervigilance, numbness, nausea, and intense anxiety.
Outward Phase (Months to Years): Individuals may appear fine on the outside but have not returned to their normal lives. This phase is crucial for seeking therapy or developing coping mechanisms.
Underground Phase: This phase occurs if feelings are not addressed, leading to regression or suppression of emotions.
Reorganization Phase: Triggered external events can cause a relapse into previous phases.
Renormalization Phase: The final stage of healing where triggers are less impactful, and the individual has progressed towards recovery.

Nursing Diagnosis

Risk for suicide or self-abuse: A common consequence of abuse.
PTSD: A prevalent disorder arising from traumatic experiences.
Ineffective relationships: Abuse can significantly damage relationships.
Spiritual distress: Victims may experience a spiritual conflict or blame God.
Risk for infection: Due to potential for STDs or pregnancy.
Chronic sorrow: Prolonged sadness and grief associated with loss and trauma.

Nursing Care Considerations

Privacy: Provide privacy for the patient to facilitate a safe and confidential environment.
Sense of Control: Grant the patient a sense of control by offering them choices, such as requesting a female nurse.
Medical History: Review medical history, including allergies, last menstrual period, and last sexual encounter.
Universal Screening: Conduct universal screening for trauma history to ensure all patients receive appropriate care.
Trauma-Informed Care: Emphasize the importance of understanding the paths of recovery for survivors.

Evidence Collection

Assessment: Assess the environment for potential weapons.
Privacy: Conduct discussions in a private setting, such as a lab or private room.
Timeliness: Evidence collection should occur within 72 hours of the assault.
Gloves: Wear gloves when collecting evidence to prevent contamination.
Paper Bags: Use paper bags to store evidence, as plastic bags can trap moisture.
Documentation: Thoroughly document all evidence collected, including jewelry, nail clippings, pictures, and clothing.

Planning and Intervention

Safety: Provide a safe and secure environment for the patient.
Escape Plan: Assist the patient in developing an escape plan if needed.
Advocacy: Advocate for the survivor's rights and support their children.
Legal Reporting: Report any required information to law enforcement, even if the patient does not want to press charges.
SANE Nurse: Consult with a Sexual Assault Nurse Examiner (SANE) when necessary.

Evaluation

Justice: Assess if the patient has received justice, such as appropriate legal action or a safety plan.
Evidence Handling: Evaluate if evidence was collected and preserved correctly.
Self-Esteem: Determine if the patient's self-esteem has increased, or if they have shown signs of healing.
Growth and Development (Children): Monitor the child's growth and development to identify any potential impacts of abuse.
Harm and Financial Issues (Elderly): Assess if the elderly patient is free from harm and financial exploitation.
Safety: Maintain your own safety as a nurse, by ensuring you are near an exit or door.
Documentation: Thoroughly document objective observations of the patient's condition and behavior.
Set Goals: Establish specific goals and objectives for the patient's care.
Evaluation: Regularly evaluate the effectiveness of the interventions and make adjustments as needed.

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Description

This quiz explores critical concepts surrounding domestic and child abuse, including the dynamics of abusive relationships and the effects of trauma on victims. It covers key indicators of abuse and guidelines for supporting victims effectively. Enhance your understanding of these pressing social issues and how to recognize and respond to them.