WEEK 11: OB (CHAPTER 9+ 23)

What is the longest of the phase of the cycle of violence?

Phase 1: Tension Building

To properly assist a victim of intimate partner violence, which action would be most appropriate for the nurse to do? Document the details. Summarize the details of the incident. Discuss the details with the victim. Confront the abuser about the details.

Document the details. Accurate documentation is critical because this evidence may support the client's case in court. Documentation must include details about the frequency and severity of violence; location, extent, and outcome of injuries; and any treatments or interventions. Documentation should always use direct quotes, and be very specific.

What are the three phases of cycle of violence

Phase 1: Tension Building Phase 2: Acute Battering Phase 3: Honeymoon

The nurse is caring for a pregnant client admitted for abdominal trauma following an assault. The nurse will monitor the client for which potential complications? Select all that apply. Spontaneous abortion (miscarriage) Placental abruption (abruptio placentae) Uterine rupture Gestational hypertension Preterm laborv

Spontaneous abortion (miscarriage) Placental abruption (abruptio placentae) Uterine rupture Preterm labor

A client who is a victim of intimate partner violence fails to report the violence primarily because of which reason? The client feels responsible for causing the incident. The client does not want anyone to know. The client thinks it will not happen again. The client feels lucky to be alive.

The client feels responsible for causing the incident. The honeymoon phase prevents many victims from reporting intimate partner violence. The victim wants to believe that the partner can really change. The client feels responsible, at least in part, for causing the incident and for the partner's well-being.

The nurse is caring for four clients. Which client will the nurse suspect is a victim of intimate partner violence? a client whose clothing is dirty and who has not seen a health care provider in the past 3 years a client whose partner refuses to attend recommended counseling for alcohol use disorder a client who states, "I am not sure" and "I cannot remember" to several of the nurses' history and physical questions a client whose partner does not leave the client's side or hospital room at any point of the day or night

a client whose partner does not leave the client's side or hospital room at any point of the day or night Indicators of intimate partner violence (IPV) include timid client, overly protective partner, a partner who speaks for the client, and unexplained injuries.

The nurse gave a presentation about intimate partner violence (IPV) to a local community group. The nurse determines more teaching is needed when a member makes which statement? "I will carefully observe my friends, family, and neighbors for signs of IPV." "Drugs, alcohol, and pregnancy can make IPV situations much worse." "I did not know that both men and women can be victims of IPV." "For the victim's safety, the victim has to learn to be careful to not set off the abuser."

"For the victim's safety, the victim has to learn to be careful to not set off the abuser." The nurse would provide additional teaching when a member states the victim has to learn how to not set off the abuser. The victim should not be told he or she causes the situations of abuse.

While talking to the nurse, a client states that every time she has a serious fight with her spouse, the client is forced to have intercourse. The client appears very disturbed when revealing this to the nurse. Which is an appropriate response by the nurse? "Sexual abuse does still happen among married couples." "Are the fights a result of something you have done wrong?" "This behavior is called intimate partner violence." "Such behavior is not okay and I am calling the authorities."

"This behavior is called intimate partner violence." The nurse should tell the client that this behavior indicates intimate partner violence because the spouse forces intercourse against the client's will. The nurse should also explain that the client is in no way responsible for such incidents and has a right to refuse sexual intimacy. There is no justification for intimate partner violence, and the client should not regard it as expected behavior of a married couple. Some states require health care professionals to report intimate partner violence, but not all. The nurse would discuss the situation with the client first and act based on local laws.

What are the ABCDES of caring for the abused women?

A - Assuring B - Belief C - Confidentiality D - Documentation E - Education S - Safety

A client is receiving treatment for injuries sustained during a fight with a partner. The nurse observes the partner visit the client daily in the hospital and appears very solicitous and contrite. The client states, "My partner always apologizes and brings gifts after a fight." Which response by the nurse is appropriate? "Sometimes abusive partners try to apologize but this does not mean the person wants to change." "Your partner seems to be genuinely contrite. I understand why you stay with your partner." "You both need to see a counselor to figure this out. Your partner will go if your partner truly loves you." "Although your partner seems sorry, often an abuser will continue to repeat the behavior in the future."

"Although your partner seems sorry, often an abuser will continue to repeat the behavior in the future." The nurse should clearly explain to the client that whatever the cause of the incident, no one deserves to be a victim of intimate partner violence and abusive behaviors are often repeated.

A nurse is screening a client for intimate partner violence using indirect questions. Which question would the nurse most likely ask? "I know it can be difficult to talk about, but does your partner hit you?" "Have you ever been abused?" "Clients with your injuries are often abused. Is anything like this happening now?" "It's okay to talk about this subject. Are you in an abusive relationship?"

"Clients with your injuries are often abused. Is anything like this happening now?" "Does your partner hit you?" or "Have you ever been or are you now in an abusive relationship?" are direct questions. They are focused and address the topic with the client directly. If that approach feels uncomfortable, indirect questions can be used, such as "We see many clients with injuries or reports like yours, and often they are being abused. Is that what is happening to you?" or "Many people in our community experience abuse from their partners. Is anything like that happening in your life?" With either approach, nurses need to maintain a nonjudgmental acceptance of whatever answers the woman offers.

The nurse is caring for a pregnant client who states her spouse verbally abuses her. Which response by the nurse is a priority? "If your spouse becomes physically abusive, you have to leave for your and your unborn child's safety." "Try to avoid making your partner angry to prevent the abuse from escalating until you are able to move out." "Intimate partner violence often gets worse during pregnancy and stress. Do you have a safety plan in place?" "Has your spouse ever hit you in the past or forced you to perform sexual acts you did not consent to doing?"

"Intimate partner violence often gets worse during pregnancy and stress. Do you have a safety plan in place?" The nurse would be focused on the safety of the client and her unborn child. Ensuring the client has a safety plan is a priority.

What are the four types of abuse?

- Emotional abuse - Physical abuse - Financial abuse - Sexual abuse

Which initial interview technique would be least effective in gathering information from a suspected abuse victim? Ask open-ended, nonjudgmental questions of the client. Avoid questions that appear accusatory such as "Why don't you just leave him?" Ask the client to strip down and show you where she has been hurt. Convey to the client that the abuse is not her fault, such as "No one deserves to be treated like this."

Ask the client to strip down and show you where she has been hurt. When interviewing a suspected abuse victim initially, the nurse needs to be supportive and respectful of her. Always talk to the victim alone and in a private place. Ask simple, direct, open-ended questions that allow the client to describe her experiences. Never imply that the woman is in any way responsible for the abuse by asking questions about why she stays with the abuser or what she did to make him mad. Never ask the client to strip for you to inspect her body initially. The nurse needs to establish a rapport with the woman first so trust can be established.

A pregnant client discloses to the nurse that she has been abused by her spouse for the past 4 years. Which action will the nurse take next? Determine why the client has remained in an abusive relationship for 4 years. Encourage the client to seek refuge at a gender-specific victims' shelter. Assess the client for signs of intimate partner violence. Perform an ultrasound to assess the fetus for any injuries.

Assess the client for signs of intimate partner violence. Pregnancy and birth are trigger points for intimate partner violence because the abuser may experience a sense of loss of control. During pregnancy, the mother and fetus take priority, and the abuser attempts to maintain or regain control by abusing the woman. The nurse would assess the client and document all indications of intimate partner violence. The nurse would notify the health care provider of findings and discuss a safety plan and provide information on resources to the client. The nurse would assess the fetus for injury after assessing the client, paying close attention to the client's abdominal and perineal areas.

A client has been seen and treated in the emergency room several times for injuries that are deemed suspicious. The client is reluctant to participate in a screening process. How best can the nurse provide reassurance to this client? Being nonjudgmental Giving assurances of help Establishing a plan to protect the client Having the client be honest about the injuries

Being nonjudgmental During the screening process the victim is most likely to be uncomfortable and not want to participate. Victims are concerned about being judged by the interviewer, provoking more violence, and being disappointed by the provider's response to the disclosure. The nurse can best help the victim participate in screening by ensuring confidentiality and being nonjudgmental.

The nurse is caring for a client in an abusive situation. In developing a plan of care, which factors does the nurse consider? Select all that apply. It often takes several attempts before a woman leaves an abusive situation. Economic factors rarely play a role in the decision to stay in abusive relationships. Until children reach school age, they are usually not affected by parental discord. Women in abusive relationships usually feel isolated and unsupported. Substance use is a common factor in abusive relationships.

It often takes several attempts before a woman leaves an abusive situation. Women in abusive relationships usually feel isolated and unsupported. Substance use is a common factor in abusive relationships. Factors that need to be considered include the following: It often takes several attempts before a woman leaves an abusive situation; women in abusive relationships usually feel isolated and unsupported; and substance use is a common factor in abusive relationships. Economic factors are often a factor because the partner/abuser usually controls the financial resources. Toddlers and preschool-age children can be affected by parental discord and intimate partner violence (physical, emotional, verbal) that takes place in the household.

What is the shortest phase of the cycle of violence?

Phase 2: Acute Battering

_______________ and ________________ are central to the dynamic of intimate partner violence

Power and control are central to the dynamic of intimate partner violence.

The nurse notes injuries indicating intimate partner violence (IPV) when assessing a client. When questioned, the client confirms the nurse's suspicions. Which nursing action is a priority? Provide the client information on resources for IPV victims. Encourage the client to move forward and not dwell on past abuse. Document the findings in the client's medical record. Refer the client to a psychologist for counseling.

Provide the client information on resources for IPV victims. The nurse should offer referrals to the client, such as safety plans, support groups, and shelters, to ensure the client remains safe. The nurse would document the findings and client statements; however, the client's immediate safety is a priority. A referral may be needed. The nurse would further assess the client to determine if a referral is appropriate for this client at this time. The nurse should help the client cope with the incident rather than telling the client to forget about it.

A 13-year-old adolescent is admitted to the health care facility with vaginal bleeding. A genital examination reveals unhealed wounds likely resulting from female genital cutting. The client has limited proficiency in the dominant language. The service of an interpreter is employed. What should the nurse keep in mind when interacting with this client? The client is still a child, so the nurse should convey important information in precise medical terms to ease understanding. Allow the interpreter to question the client directly to assist with data gathering. Use pictures and diagrams to supplement the questions and answers of the client's understanding. Condemn the cultural practice, and explain to the young girl why it is wrong.

Use pictures and diagrams to supplement the questions and answers of the client's understanding. The nurse should use pictures and diagrams to ensure that the client understands what is being asked and explained. Instead of using medical terms, the nurse should use simple, accurate terms as much as possible. Condemning the practice of female genital cutting will only alienate the girl and serve no useful purpose.