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37 Cards in this Set
- Front
- Back
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__ is actual/threatened physical, sexual, psychological, or emotional abuse by spouse, ex-spouse, boyfriend, girlfriend, ex-boyfriend, ex-girlfriend, or date
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Intimate Partner Violence (IPV)
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barriers to screening for IPV
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lack of effective interventions once victims ID
fear of offending patient by asking some provider bias limited time to conduct screening |
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What are the 3 stages of IPV cycle of violence?
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1: tension building, dominant partner becomes more volatile and violent in response to minor incidents
2: violence 3: honeymoon, partner is contrite and realizes has violated bounds, becomes apologetic and showers with affection/gifts |
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What can be utilized in assessing the level of danger in IPV?
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Danger Assessment 2 Instrument (DA-2)
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What consist of Battered Woman Syndrome?
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direct trauma effects, psychological difficulties, and compromised coping mechanisms
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When screening for IPV, what are the 3 As that should be used?
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Ask about abuse
Assess safety Advocate for victim |
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HITS questions
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How often has your partner Hurt? Insult? Threaten? Scream?
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SAFE assessment
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Stress/ safety
Afraid/ abused Friends/ family Emergency plan |
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RADAR assessment
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Routine screening
Ask direct questions Document findings Assess safety Review options/ referrals |
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__ describes manual, oral, or genital contact with genitalia of victim without victim's consent
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Sexual Assault
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What are coital forms of sexual assault?
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rape and incest
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What is the primary motive for rape?
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agression
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__ is act of forcing an individual to have sexual intercourse against will and is usually done so by someone the victim knows
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Rape
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__ involves sexual activity with individual unable to consent either b/c under age/ consciousness altered by illness, sleep, drugs, and etoh
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Statutory Rape
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What are the types of behaviors and motivations of rapists?
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Opportunistic (impulsive, suspended judgment, etc)
Pervasively angry (impulsive, enraged, injure/kill, etc) Sexualized (obsessive, calculated, planned) Non-sadistic (may not injure/resistance deters) Vindictive (impulsive, calculated, violent, kill, degrade) |
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What are the 5 phases of rape trauma?
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immediate rxn during attack
disorganization denial reorganization integration and resolution |
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What are excellent for documentation and notation of precise location of any cuts/bruises from rape?
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sketches/photos during physical exam
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What is the presence of semen indicative of after rape?
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Only that the victim had sexual intercourse, not necessarily with the attacker
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What is the most critical part of the physical exam after rape?
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pelvic exam
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What concentration in semen is important in sexual abuse lab studies?
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acid phosphatase
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What is an option regarding pregnancy in a woman after rape?
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To be effective, pregnancy prophylaxis should begin within 72hrs of assault (Plan B, Previn, OCs)
If any of the methods fail, therapeutic abortion is recommended d/t teratogenic effects of meds |
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What are the 3 rxn phases to rape?
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1st phase: acute rxn period
2nd phase: pseudo adjustment period 3rd phase: adjustment/reorganization phase |
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__ has under reported incidences, occurs in families of every racial and ethnic background and at every educational and income level, has no age-group that is spared, is estimated 1:5 in girls and 1:10 in boys before 18y/o, and most are victims of someone they know
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Sexual Abuse of Children
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What is included in the definition of rape/ sexual abuse with children?
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fondling, oral and anal sodomy, incest, pornography and prostitution
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__ is sexual contact between family members
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incest
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risk factors of sexual abuse in children
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single parent family
divorced/separated parents mental illness fhx abusive parents hx homeless families/ overcrowded units working parents and left home alone empty house after school |
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signs of sexual abuse in children
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school performance worsening
irritability, poor sleep, nightmares, withdrawal depression, temper tantrums, excess masturbation sexually related remarks genital/rectal pain, trauma, dilation, infection unusual physical complaints persistent ab pain, HA |
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__ is failure of reproductive-age couple to conceive after period of >1yr of regular coitus without contraception
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Infertility
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What are the types of infertility?
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Primary: never established pregnancy
Secondary: conceived at least 1 but currently unable Sterility: conception impossible and irremediable |
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Factors that affect fertilty
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>40y/o
freq of coitus nutrition environmental/occupational chronic dz smoking etoh drugs STIs stress |
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What are the factors that affect infertility?
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spermatogenesis (male factor)
ovulation (female factor) mucus and sperm interaction (cervical factor) endometrial integrity/cavity size/shape (uterine factor) oviductal patency/anatomic ovary relationship (tubal) insemination (coitus factor) |
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What is the indirect means (practical) way of documentation of ovulation?
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basal body temp
elevated blood progesterone level endometrial bx |
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What is produced by the corpus luteum that must be sufficient to prepare endometrium for implantation and maintenance of pregnancy?
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progesterone
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What are reasons for ovulatory defects?
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hypothalamic pituitary insufficiency
thyroid dz adrenal d/o emotional disturbances metabolic/nutritional d/o excessive exercise |
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tx of infertilty
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therapeutic/artificial insemination
in vitro fertilization and embryo transfer (IVF-ET) gamete intra fallopian transfer (GIFT) *clomiphene (nonsteroidal estrogen agonist-antagonist) menotropin therapy (pergonal, humegon) restoration of tubal patency metroplasty emotional care adoption |
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__ is sexual complaints related to desire, arousal, orgasm, and pain, common in women that have NO drug approved to tx
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female sexual dysfunction
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possible female sexual dysfunction therapy
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estrogen (vaginal complaints)
androgens (sexual desires) bupropion(diminished libido and anorgasima) sildenafil (little female effect) prostaglandins |
