Csn Mental Health Survivors Of Abuse & Violence

Front 1

What is the purpose of domestic violence?

Back 1

Power and Control

Front 2

When is a women in an abusive relationship at greatest danger?

Back 2

When she attempts to leave

Front 3

What are some reasons a women stays in an abusive relationship?

Back 3

-emotional
-economic
-fear
-shame/embarrassment
-clergy/society
-children
-housing/shelter

Front 4

What are some physical indicators of possible partner abuse?

Back 4

-general appearance
-skin
-musculoskeletal
-genital/rectal
-abdominal
-neurological

Front 5

What are some nursing interventions for partner violence?

Back 5

-Ensure privacy/confidentiality
-Communicate to victim, "It's not your fault"
-Medical attention for injuries
- Take photos w/pt permission
- Document thoroughly
-Refer pt to counseling &/or support group (YWCA)
-Provide pt w/list of community resources
-Develop and/or discuss w/pt the need for a safety plan

Front 6

DEF
Child Abuse Prevention & Treatment Act (CAPTA)

Back 6

Defines child abuse and neglect as any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation or an actor failure to act which presents an imminent risk or serious harm.

Front 7

DEF
Child Psychological Abuse

Back 7

Behaviors that are rejecting, degrading/devaluing, terrorizing, isolating, corrupting, exploiting, denying essential stimulation or availability and unrealistic & inconsistent parenting

Front 8

Who is at risk for child abuse?

Back 8

-Children <3yrs at risk for fatal abuse
- Premature infants, handicapped & developmentally delayed children
- Females are at >risk of physical, emotional and sexual abuse
-Males are at >risk of more serious injuries and of emotional neglect

Front 9

What are characteristics of a child physical abuser?

Back 9

-Immature
-Low self-esteem
-Unrealistic expectations of children
-Poor impulse control
-Few external support systems
-For physical abuse, male>female
-For neglect, female>male

Front 10

What should be assessed in a suspected child abuse victim?

Back 10

-Discrepancies in parents' explanation vs the physical findings
-Delay in seeking tx
-Failure to use closest hospital
-Child hx of multiple injuries
-Parent/child relationship during the interview

Front 11

What are some physical indicators of possible child abuse and neglect?

Back 11

-General appearance
-Multiple injuries
-Skin
-Burns
-Fractures
-Head Injuries
-Abdominal injuries
-Injuries to eyes, ears, nose, mouth
-Others: Munchausen's by proxy, Deprivational syndrome

Front 12

What are nursing interventions for a suspected abused child?

Back 12

-Non-threatening, nonjudgmental approach w/parents
-Understand children do not want to betray their parents
-Complete physical of child
- Use of dolls as age appropriate
- Make appropriate referrals to child protective services
-Accurate and detailed documentation

Front 13

DEF
Childhood Incest

Back 13

Any type of exploitative sexual experience between relatives or surrogate relatives before the victim is 18 y.o.

Front 14

DEF
Exploitative acts

Back 14

Behaviors that the perpetrator uses for his/her own sexual gratification

Front 15

What are the characteristics of a family that may be experiencing incest

Back 15

-Appears overtly "normal", Highly dysfunctional
-Enmeshed- relatively isolated from those outside the family, focuses most energy on family relationships
-Poor boundaries
-Role reversal

Front 16

What are the characteristics of an incest offender?

Back 16

-Most cases not reported, therefore data is limited
-Diverse populations
-89%males
-# of juvenile offenders on the rise
-Most offenders do not have a mental illness

Front 17

What are the characteristics of non-offending (incest)
parent?

Back 17

-Mother maybe blamed by husband for not satisfying, needs, mother then expects daughter to take over role

OR

-Mother may deny it or blame the daughter for encouraging it

Front 18

What are the characteristics of the abused (incest) child?

Back 18

-Usually the oldest daughter
-Average age is 8-9yo
-Average duration in 7 years
-Secret is often never revealed

Front 19

What are common symptoms found in a child victim of incest?

Back 19

-Sexually acting out behaviors
-PTSD
-Anxiety, fear
-Depression
-Somatic complaints
-Problems in school

Front 20

What are the long term effects of child (incest) abuse ?

Back 20

-Depression
-Anxiety disorders
-Dissociation
-PTSD
-Self-damaging behaviors

Front 21

What are some physical indicators of possible childhood sexual abuse?

Back 21

-General appearance
-Probable physical indicators
-High-risk family hx indicators
-Behavioral indicators
-Possible psychosocial indicators

Front 22

What behaviors may be assessed in a child victim of incest?

Back 22

-Rebellious & delinquent
-Wite hdraw from others
-Blame themselves
-Guilt ridden
-Try to be the "good" child

Front 23

What should be assessed in a suspected child victim of incest?

Back 23

-Physical exam
-Interview w/child & family
-Outside collateral (teachers, babysitters, psychological testing)

Front 24

What are nursing interventions for a child (incest) victim?

Back 24

-Notify CPS
-Medications, PRN
-Encourage discussion of feelings
-Reassure child she is NOT to blame
- Document thoroughly
FOR YOUNG CHILDREN
-use play/group therapy and cognitive/behavioral therapy
FOR ADULT SURVIVORS
-Antidepressant meds for depression, anxiety & PTSD
-Therapy: group, cognitive/behavioral, hypnotherapy, imagery & art therapy

Front 25

What are the 3 categories of elderly abuse?

Back 25

-Domestic
-Institutional
-Self neglect or self abuse

Front 26

What are the 6 types of elderly abuse recognized by the National Center of Elder Abuse (NCEA)

Back 26

-Physical abuse
-Sexual
-Emotional or psychological
-Neglect
-Abandonment
-Financial exploitation

Front 27

What are the characteristics of an abused elder?

Back 27

-NCEA defines older adults as >60 yo
-Females are abused more often than males
-Median age is 77.9 yo
->80 yo is most vulnerable

Front 28

What are the characteristics of the Abuser (elderly abuse)?

Back 28

-Most likely is the person who lives w/elderly (son, daughter or spouse)
-Children of the elderly are the most common abusers followed by spouses, other relatives and grandchildren

Front 29

What are some theories of elderly abuse?

Back 29

-Biologic- psychopathology of abuser
-Social learning- dependency (financial and relational), social isolation, transgenerational violence
-Environmental -external stress
*The elder can remain in an abusive situation unless declared incompetent by a judge

Front 30

What are physical indicators of actual or potential elder abuse/neglect?

Back 30

-General appearance
-Skin
-Abdominal/rectal
-Musculoskeletal fractures
-Genital/urinary
-Neurological

Front 31

What are nursing interventions for abused elderly pt?

Back 31

-Balance safety with autonomy
-Report suspected abuse
-Give pt available resources (hotlines, meals on wheels, senior day care centers, respite, home health, support groups)

Front 32

Definition of rape including recent expansions

Back 32

Forced sexual penetration of a non-consenting person including penile-vaginal or anal penetration, cunnilingus, fellatio or any intrusion of any part of a person's body

Front 33

DEF
Non-Consent

Back 33

-Physical force
-Threat of physical force
-Inability of the victim to consent for reasons such as age, developmental disability and intoxication

Front 34

What are the characteristics of a rapist?

Back 34

-MOST perpetrators and victims are caucasian
-Most cases, victims & perpetrators are of the same race
-Most cases, the victim is acquainted w/the perpetrator; rape by a stranger in exception rather then the rule

Front 35

What are the date rape drug?

Back 35

-Rohypnol
-GHB (gamma hydroxybutric acid)

Front 36

What are the phases of rape trauma syndrome

Back 36

-Acute Phase (0-2 wks after rape)
-Long-term phase (>2weeks after the rape)

Front 37

What are the characteristics of the acute phase of rape trauma syndrome

Back 37

- Pt begins to respond to the rape with fear, anxiety, disbelief, anger and shock
-Physical response includes sleep disturbances, nightmares, body aches & pains r/t rape, fatigue and loss of appetite

Front 38

What are the characteristics of the long-term phase of rape trauma syndrome?

Back 38

-Pt works toward integration and resolution of the experience
-This may include empowerment and reconnecting w/others

Front 39

What should be assessed in rape victim?

Back 39

-Assess physical trauma (use body map & ask permission to take pictures
-Assess psychological trauma (write down verbaism statements of pt)
-Assess available support system (Often partners and family members do not understand about rape and may not be best supports at this time)

Front 40

What are the assessment guidelines for rape victims?

Back 40

-Assess level of anxiety (If pt is in severe to panic level of anxiety, they will not be able to problem solve or process info.)
-ID community support (attorneys, support groups, therapists) who work in the area of sexual assault.
-Encourage pt to tell their story but DO NOT press them to do so.

Front 41

What are some nursing interventions for sexual abuse/assault?

Back 41

-Follow institution's protocol for sexual assault
-Do not leave the person alone
-Maintain a nonjudgmental attitude
-Ensure confidentiality
-Encourage the person to talk; listen empathetically
-Emphasize that the person did the right thing to save his/her life
-Explain everything that you are going to do
-Ascertain forensic exam is done & specimens are obtained w/pt permisssion
-Alert pt as to what s/he might experience during long-term phase
-Arrange for follow-up support

Front 42

DEF
Paraphilias

Back 42

Sexual expressions characterized by "recurring, intense sexually arousing fantasies, sexual urges or behaviors generally involving (1)nonhuman objects (2) suffering or humiliation of oneself or one's partner or (3) children or nonconsenting persons, that occur over a period of at least 6 months

Front 43

What are the types of paraphilias?

Back 43

-Exhibitionism (exposing genitals to unsuspecting stranger)
-Fetishism (involves nonhuman objects)
-Frotteurism (touching/rubbing against nonconsenting person)
-Pedophilia (children <13yo)
-Sexual Masochism (being made to suffer)
-Sexual Sadism (psychological/physical suffering of others)
-Transvestic Fetishism (cross-dressing)
-Voyeurism (watching person who is naked)
-Paraphilia Not Otherwise Specified