N303 - Ch 6 Ob

Front 1

What is the most common form of violence experienced by women worldwide?

Back 1

Intimate Partner Violence (IPV)

Front 2

What is the incidence of domestic violence?

Back 2

1 out of every 6 women

Front 3

What is intimate partner violence?

Back 3

The actual or threatened physical, sexual, psychologic, or emotional abuse by a spouse, ex-spouse, boyfriend, girlfriend, ex-boyfriend, ex-girlfriend, date, or cohabiting partner

Front 4

In which population is violence the second leading cause of injuries?

Back 4

Women age 15 to 44 years

Front 5

What is the severity of violence significantly correlated with?

Back 5

The severity of depression

Front 6

What often keeps women from reporting abuse?

Back 6

The power imbalance and the concept that family problems are private (and should be kept private)

Front 7

What is aggression?

Back 7

A positive force that connotes boldness, forcefulness, energy, and enterprise

Front 8

Which psychosocial disorders are prevalent in people who batter?

Back 8

Borderline or antisocial disorders

Front 9

What are the characteristics of a potential batterer?

Back 9

1. Low self-esteem
2. Problems with abandonment, loss, helplessness, dependency, insecurity, and intimacy
3. Inadequate verbal skills, especially difficulty expressing feelings
4. Deficits in assertiveness
5. Personality disorders frequently diagnosed
6. Low frustration tolerance (loses temper easily)
7. Higher incidence of growing up in an abusive or violent home
8. Denies, minimizes, blames, and lies about own actions
9. Violence is consistent with his view of himself and the world; it is an acceptable way of dealing with everyday life
10. Inability to empathize with others
11. Rigidity in male and female behaviors (sex-role stereotypes)
12. Perceptions of self as "special" and deserving special attention for being the provider, protector
13. Substance abuse problems are common
14. Display of an unusual amount of jealousy (e.g. expects partner to spend all of her time with him or keep him informed of her whereabouts)

Front 10

What areas of the brain are believed to play in a role in aggressive behavior?

Back 10

The limbic system, the frontal lobes, and the hypothalamus

Front 11

What neurotransmitters at increased levels foster aggressive behavior?

Back 11

Norepinephrine and L-dopa

Front 12

What inhibits aggressive behavior?

Back 12

The amino acid gamma-aminobutyric acid (GABA)

Front 13

What aspects of the structure and dynamics of the family often set the stage for violent behaviors?

Back 13

1. Ascribed roles of family members
2. The amount of time spent together
3. The private nature of the family
4. The intensity of emotional involvement
5. Stress and conflict inherent in families

Front 14

What is prominent in violent families?

Back 14

1. Lack of emotional support experienced by children

2. The awareness that people who love each other can be violent to each other

Front 15

What social factors are significant in violent behaviors?

Back 15

1. History of violence in family

2. Poverty and oppression

3. Low income, with its subsequent stress, and limited resources making it difficult to meet basic needs

4. Unemployment

5. Difficulty in maintaining interpersonal ties

6. Disruption in marriages

7. Single-parent families

Front 16

What are the forms of violence against women?

Back 16

1. Wife battering
2. Stranger and acquaintance rape
3. Incest
4. Sexual harassment in the workplace

Front 17

What are the types of physical and sexual violence?

Back 17

1. Coercion and threats
2. Economic abuse
3. Using male privilege
4. Using children
5. Intimidation
6. Emotional abuse
7. Isolation

Front 18

What cultural practices support abuse of women?

Back 18

The objectification of women and power inequalities in human social arrangements

Front 19

What are the terms used to describe a pattern of assaultive and coercive behaviors inflicted by an intimate partner?

Back 19

1. Intimate partner violence
2. Wife battering
3. Spouse abuse
4. Domestic or family violence

Front 20

Why do battered women often believe that they are to blame for the violence?

Back 20

Because they believe that they are "not good enough, not efficient enough, not pretty enough"

Front 21

What does the traumatic bonding with the abuser hinge on?

Back 21

1. Loyalty
2. Fear
3. Terror
4. Learned helplessness

Front 22

What influences intimate partner violence?

Back 22

The value women place on their societal role - passive, submissive female roles vs. the traditional male dominant roles

Front 23

How do women in nonviolent relationships differ from women in abusive relationships?

Back 23

Women in nonviolent relationships have traits of assertiveness, independence, and willingness to take a stand

Front 24

What are the characteristics of battered women?

Back 24

1. Compassion
2. Sympathy
3. Yielding attitude
4. Social isolation

Front 25

What are battered women often diagnosed with?

Back 25

Posttraumatic stress disorder (PTSD)

Front 26

What conflicting realities associated with IPV entrap women in the abusive relationships?

Back 26

1. The good aspects of the partner relationship and the support by the partner and others

2. The reality of the abuse, which the woman might not recognize or may minimize or deny

3. Both these realities may elicit the woman's hopefulness that things will change

Front 27

What is the incidence of IPV?

Back 27

ONE FOURTH of all women experience battering by an intimate partner

Front 28

Does pregnancy protect women from being battered?

Back 28

No, from 4% to 8% of all women who are pregnant are battered during pregnancy because they are more vulnerable

Front 29

Does battering occur only in "problem" or lower class families?

Back 29

No, IPV can occur in any family. Although lower class families have a higher reported incidence of battering, it also occurs in middle- and upper-income families. Incidence is not really known because of the tendency of middle- and upper-income families to hide their battering.

Front 30

MYTH: Battered women like to be beaten and deliberately provoke the attack. They are masochistic.

Back 30

FACT: Women are terrified of their assailants and go to great lengths to avoid a confrontation. In some cases, the woman may provoke her partner to release tension that, if left unchecked, might lead to a more severe beating and possible death.

Front 31

MYTH: Only men with psychologic problems abuse women?

Back 31

FACT: Many batterers are successful professionals, including politicians, ministers, physicians, and lawyers. Research indicates that only a small number of abusers have psychologic problems.

Front 32

MYTH: Only people who come from abusive families end up on abusive relationships.

Back 32

FACT: Most battered women report that their partners were the first person to beat them.

Front 33

MYTH: Alcohol and drug abuse can cause battering.

Back 33

FACT: Although alcohol may be involved in abusive incidents, it is not the cause. Many batterers use alcohol as an excuse to batter, and shift the blame to alcohol.

Front 34

MYTH: Women would leave the relationship if the abuse were really bad.

Back 34

FACT: Those women stay in the relationship do so out of fear and financial dependence. Shelters have long waiting lists.

Front 35

MYTH: Batterers and battered women cannot change.

Back 35

FACT: Counseling may effectively help both batterers and battered women.

Front 36

Is battering random and/or constant?

Back 36

No, it occurs in repeated cycles

Front 37

What is the pattern of violence?

Back 37

1. Period of increasing tension leading to the battery

2. Followed by a period of calm and remorse in which the partner displays kind, loving behavior and pleas for forgiveness

3. This "honeymoon" phase lasts until stress or other factors cause conflict and tension mount again toward another episode of battering

4. Over time, the tension and battering phases last longer, and the calm phase becomes shorter, until there is no honeymoon phase

Front 38

What are the phases of violence?

Back 38

1. Tension-building State
2. Acute Battering Incident
3. "Honeymoon" Phase

Front 39

What is the tension-building state?

Back 39

Phase 1. Tension gradually escalates. The batterer expresses dissatisfaction and hostility without violent outbursts.

Front 40

What is the acute battering incident?

Back 40

Phase 2. Man's uncontrollable discharge of the tension has been built up to "teach the woman a lesson". Can last few hours to several days.

Front 41

What is the "honeymoon" phase?

Back 41

The batterer feels remorse and apologizes profusely. There are displays of kindness and contrite, and loving behaviors. Promises of it never happening again commences.

Front 42

What are the types of behaviors used by a batterer?

Back 42

1. Slaps
2. Punching, especially to face and head
3. Kicking
4. Stomping
5. Choking
6. Pushing
7. Breaking bones
8. Burns from irons
9. Mutilation from knives and guns

Front 43

Where do battered women sustain most of their injuries?

Back 43

Face, buttocks, and hands and forearms as she tries to protect herself

Front 44

What happens with battering during pregnancy?

Back 44

Most women abused before pregnancy will be abused during the pregnancy, and the incidence may escalate. Abuse may also happen for the first time during pregnancy.

Front 45

What maternal complications are related to being in an abusive relationship?

Back 45

1. Depression
2. Suicide
3. Low weight gain
4. Infections
5. Substance abuse

Front 46

What causes pregnancy to become a time of initial or increased battering episodes?

Back 46

1. The biopsychosocial stresses of pregnancy may strain the relationship beyond the couple's ability to cope, and frustration is followed by violence

2. The man may be jealous of the fetus, resenting the intrusion into the couple's relationship and the woman's displacement of attention

3. The man may be angry at the unborn child or the woman

4. The beating may be the man's conscious or subconscious attempt to end the pregnancy

Front 47

What psychologic problems can arise from being battered during pregnancy?

Back 47

1. Mother may be so physically and emotionally drained that she may have difficulty bonding with her infant

2. Mother may be at risk of becoming an abusive mother whether or not she remains in the abusive relationship

Front 48

What health problems can arise from being battered during pregnancy?

Back 48

1. Headaches and pain
2. High levels of depression
3. GI symptoms due to chronic stress
4. HTN and chest pain
5. STIs
6. Bleeding
7. UTIs, chronic pelvic pain, and genital trauma
8. PTSD
9. Substance abuse

Front 49

What difficulties in the pregnant woman can assist the nurse in identifying battering during pregnancy?

Back 49

1. Consumption of an inadequate diet including too little milk and milk products

2. Lack of sleep

3. Minimal forms of self-relaxation

4. Improper care of self

Front 50

What complications does battering cause to the fetus?

Back 50

1. Fetal injury
2. LBW
3. Preterm birth
4. Placental abruptions
5. Neonatal death

Front 51

Which group is abused at higher rates than adult pregnant women?

Back 51

Pregnant adolescents, because of their inexperience and their misinterpretation of violence and jealousy for love and devotion

Front 52

What may be the biggest risk facing pregnant women?

Back 52

IPV-related homicide

Front 53

When does care of the battered woman begin?

Back 53

With the nurse's assessment

Front 54

What are the nurse's preparation for care of the battered woman?

Back 54

1. Exploration of attitudes toward women in abusive situations
2. Awareness of feelings that may result in judgmental communication
3. Knowledge about the aspects of IPV

Front 55

What do battered women desire from health care providers?

Back 55

1. That health care providers take an active role; that is, to provide documentation, protection, immediate response, to give options, and to be there for the survivor later

2. Treated with respect and concern

Front 56

What type of women are more likely to seek assistance?

Back 56

1. Women who are beaten frequently and severely

2. Those who have not experienced or witnessed family violence in their family of origin

3. Those who see an alternative to life in an abusive relationship, specifically women with jobs

Front 57

Why are battered women reluctant to seek help?

Back 57

1. The need to avoid stigma associated with the nature of the family violence

2. The fear that they will not be believed

3. The fear of reprisal from their abusers

4. The desire to avoid involvement with police

Front 58

What is the nurse's responsibility regarding all women entering the health care system?

Back 58

All women entering the health care system are at risk for abuse, so nurses must assess them for potential abuse since this may be the first and only contact battered women have with someone outside the abusive relationship

Front 59

What information provides clues to violence or potential for violence?

Back 59

1. How the woman and her partner resolve conflict

2. What happens when the woman's partner becomes angry

3. Whether fighting occurs during disagreements

4. When such fighting occurs, if it ever escalates to restraining or physical means

Front 60

What can nurses say to help the woman disclose information of potential violence?

Back 60

"Many people (families) have difficulty in expressing anger or dealing with conflict. What is it like for you and your partner?"

Front 61

What questions should be asked of all women to assess for potential violence?

Back 61

1. Are you with a spouse or partner who threatens or physically hurts you?

2. Within the past year or in this pregnancy has anyone hit, slapped, kicked, or otherwise hurt you?

3. Has anyone forced you to have sexual activities that made you uncomfortable?

Front 62

What are some cues to abuse?

Back 62

1. Delay in seeking medical assistance (hours or days)
2. Missed appointments
3. Vague explanation of injuries
4. Nonspecific somatic complaints
5. Social isolation
6. Lack of eye contact
7. A husband or partner who does not want to leave the woman alone with the primary health care provider
8. Substance abuse

Front 63

Why would battered women be too embarrassed to report abuse?

Back 63

They believe the abuse is a result if their inadequacies

Front 64

How can nurses help women disclose the violence she is experiencing?

Back 64

1. Asking the women directly about abuse
2. Telling her that similar injuries are common in women who have been abused
3. Pointing out that she is not responsible for another's violence behavior

Front 65

What should be observed for during the physical examination?

Back 65

Injuries to face, breasts, abdomen, and buttocks. These injuries may be old or new and may range from minor bruising to serious injuries.

Front 66

What findings may be noted during the psychosocial assessment?

Back 66

1. Anxiety
2. Insomnia
3. Self-directed abuse
4. Depression
5. Smoking
6. Drug or alcohol abuse

Front 67

What physical signs indicate potential abuse?

Back 67

1. Injuries to face, breasts, abdomen, and buttocks

2. Fractures that required significant force or that would rarely occur by accident

3. Multiple injuries at various stages of healing

4. Patterns left by whatever might inflict injury, such as teeth, utensils, fists, or hot objects (such as irons)

Front 68

What is a major factor in addressing abuse?

Back 68

Identify the woman as a survivor, not a victim. Victim connotes someone who is harmed, is made to suffer, and has no control. Survivor is an empowering term that connotes coping and decision making in relation to taking control of one's life.

Front 69

How do women, who have identified their abuse, appear?

Back 69

Passive, hostile, anxious, depressed, or hysterical because they may think they are at the mercy of the abuser's temper. In addition, they may feel embarrassed, afraid, angry, sad, and shocked.

Front 70

What are the ABCDEs of caring for the abused woman?

Back 70

1. A = reassuring the woman that she is not ALONE

2. B = expressing the BELIEF that violence against women is not acceptable in any situation and that it is not her fault

3. C = CONFIDENTIALITY of the information being shared, because women are afraid of retaliation

4. D = descriptive DOCUMENTATION

5. E = EDUCATION, especially about the cycle of violence

6. S = SAFETY, the most significant part of the intervention

Front 71

What must be documented?

Back 71

1. The woman's quoted statement(s)

2. Accurate descriptions of injuries and a history of the first, worst, and most recent incident of violence

3. The woman's consent, evidence, or photographs