Maternity Exam #3: Vulnerable Populations

how long after bariatric surgery are women advised to use an effective method of birth control?

18 months

gender

A social construct that attributes a designation of male or female to patterns of behavior, dress, personality, experience, etc.

gender role conformity

A statement of the degree to which a person conforms to the person's gender identity.

The nurse is caring for a victim of intimate partner violence who needs emotional support. What nursing actions are appropriate for this client? Select all that apply. Allow the client to make as many decisions as possible. Encourage the client to attend support groups. Tell the client how your friend dealt with intimate partner violence. Explain how alcohol can cause intimate partner violence. Teach strategies for problem-solving and stress management.

Allow the client to make as many decisions as possible. Encourage the client to attend support groups. Teach strategies for problem-solving and stress management.

A client with multiple bruises comes to the clinic for treatment. The client appears withdrawn and quiet when communicating with the nurse. The spouse accompanies the client to the exam room and begins to answer all the questions the nurse asks the client. Which action will the nurse take next?

Escort the client to a private area to complete the assessment.

sexual attraction

Experiencing erotic and/or romantic attraction to one or more genders; commonly categorized as heterosexual, homosexual, bisexual, and pansexual.

natal sex

The sex assigned to a person at the time of birth.

Postexposure prophylaxis (PEP)

Treatment administered to an individual after exposure to an infectious disease such as HIV especially after rape

Transwoman

a biological male who identifies and presents as a woman

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

female genital mutilation (FGM) (clitoral circumcision)

a culturally accepted procedure done to pre-pubescent females in Sub-Saharan countries through the world as an attempt to control and dominate female's pleasure of sex that is thought to prevent promiscuity, infifelity, mental illness, and female masturbation

panic attack with agoraphobia

a panic attack including fear of leaving the house or home

PIMP (postitutes innocent minors for profit)

a person who offers victims of human trafficking something they need, want, or good in order to coerce someone

USPSTF

a screening questionnaire for depression and adhedonia

bariatric surgery

a surgery that is conducted to combat obesity when traditional methods of weight loss such as dietary modification and exercise are ineffective

acute traumatic stress disorder

a type of anxiety in which PTSD symptoms occur within 2 days-4 weeks after a traumatic event

phobia

a type of anxiety that consists of a persistent irrational fear of objects or situations that is understood to be irrational

social anxiety disorder

a type of anxiety that consists of a stronge, persistent fear of social performances or situations where on fears that she will embarass herself

generalized anxiety disorder

a type of anxiety that consists of excessive worry that leads to cognitive difficulties and somatic distress in which symptoms persist for at least 6 months

PTSD

a type of anxiety that consists of pychological and somatic symptoms in response to a traumatic event in which symptoms persist for at least 3 months after the event

OCD

a type of anxiety that consists of recurrent, intense obsessions and/or compuslsions that cause discomfort, impair functioning, and consume a great deal of time

Binge Eating Disorder (BED)

an eating disorder that consists of frequent over eating, defined byconsuming the equivalent of two or more meals or 2000+ calories in a given period of time, without inapropriate compensatory behaviors such as purging or excessive exercise; often associated with comorbid anxiety and depressive conditions as well as physical comborbidities from excess of calories.

A nurse is working with a victim of intimate partner violence, helping the client develop a safety plan. Which items would the nurse suggest that the client take when leaving? Select all that apply. driver's license Social Security number cash phone cards health insurance cards

driver's license Social Security number cash health insurance cards

Hepatitis B Immune Globulin

given to patients suspected to being exposed to a rapist who is HEP B positive since even if you have been vaccinated against HEP B does not mean you still have the antibodies to protect you

A nurse is assessing a rape survivor for posttraumatic stress disorder. The nurse asks the survivor, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which effect of the trauma? physical symptoms intrusive thoughts avoidance hyperarousal

intrusive thoughts The question is used to assess the survivor for intrusive thoughts that reflect the client reexperiencing the trauma. Physical symptoms would be assessed with questions about sleeping, eating, palpitations and other problems. Avoidance would be reflected in questions involving withdrawal socially, avoiding situations that remind the survivor of the rape. Hyperarousal would be noted by irritability and an exaggerated startle response.

sexual minority women

may be used to describe a woman who identifies as lesbian, bisexual, pansexual, transgender, gay, or polyamorous.

refeeding syndrome

metabolic alterations that may occur during nutritional repletion of anorexia patients; nutritional therapy can lead to this, which is potentially fatal. It is the result of a shift in fluids and electrolytes during nutritional rehabilitation. The characteristics of the condition include congestive heart failure, peripheral edema, seizures, hemolysis, rhabdomyolysis, hypophosphatemia, and hypokalemia.

Spironolactone

potassium sparing diuretic used as an antiandrogen for conversion from male to female transgender individuals; potassium levels must be monitored frequently

type II

type of FGM that consists of the removal of the clitoris and part or all of the labia minora

The nurse is caring for a client suspected of being a victim of human trafficking. Which question, when given priority by the nurse during the admission interview, demonstrates a need for additional training? "Can you leave your job if you find a better one?" "Are you working toward achieving American citizenship?" "Are you afraid of those you work for?" "Can you get in touch with your family easily?"

"Are you working toward achieving American citizenship?" Although human traffickers prey on undocumented or illegal aliens, the status of the immigration process is not a priority in determining a client's risk factors for such abuse. All the other questions assess for freedom, safety, and autonomy, all factors that are considered when assessing for such an abusive situation.

Which of the following statements probably would be most therapeutic to an adolescent seen for rape? "Try not to think any more about what happened." "Rape is a terrible crime. I'm sorry this happened." "Tell me about what happened to you." "Don't feel guilty; you did not provoke the attack."

"Don't feel guilty; you did not provoke the attack."

As part of a local college awareness program, a nurse is interviewing several of the participants about their views on rape. Which statement by a participant will lead the nurse to determine that additional education about rape is needed? "Health care providers can prevent pregnancy and sexually transmitted infection transmission after a rape." "Most victims of rape never report the episode to the local authorities or tell anyone about being raped." "What a person wears has no effect on whether that person will be assaulted by someone else." "Men and women who are raped may take several years to recover emotionally and physically."

"Health care providers can prevent pregnancy and sexually transmitted infection transmission after a rape." Health care providers can provide emergency contraceptive medication to limit the possibility of a pregnancy resulting from the rape; however, the medication is not 100% effective. Sexually transmitted infection (STI) transmission cannot be prevented after the rape has occurred. A barrier device, such as a condom, must be used during intercourse to prevent STI transmission. The majority of people who are raped never tell anyone about it, and almost two-thirds of victims never report it to the authorities. No victim invites rape or sexual assault, and what a person wears is irrelevant. It can take several years for victims to recover from rape. Medications can help initially, but counseling is necessary.

A nurse is giving a talk on violence against women to a community group and informs the attendees that violence is growing in the United States today. The nurse informs them of which alarming statistic?

1/3 to 1/2 of all U.S. women will experience some form of physical violence in their lifetimes.

PEP is most effective if started within ________ hours after exposure and is not effective if started _______ or more hours after exposure

4, 72

A client at 36 weeks' gestation presents in the emergency department with a broken arm. The client states, "I fell while cooking dinner." During the assessment, the nurse notes no prenatal care for this pregnancy, as well as bruises in multiple stages of healing on the client's abdomen, arms, and chest. What action will the nurse perform next? Notify the health care provider of the findings Ask the client how she acquired the bruises Document the findings in the client's chart Provide brochures on shelters for victims of intimate partner violence

Ask the client how she acquired the bruises

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 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.

Transman

a biological female who identifies and presents as a man

TEARS sexual assault categorization

tears, ecchymoses, abrasions, redness, and swelling) is often used to help organize and describe examination findings

sex trafficking

the recruitment, transportion, harboring, or obtaining of a person for the purpose of a commercial sex act in which the comercial sex act is induced by force, fraud, or coercion or in which the person induced to perform such act has not attained 18 years of age

type III

type of FGM that consists of the removal of all or part of the labia minora with the labia majora sewn together to cover the urethra and vagina and leaving a small hole for urine and menstrual fluid

Type I FGM

type of FGM that consists of the removal of the prepuce only or additionally partial or total removal of the clitoris

sexual violence

unwanted sexual experiences, unwanted sexual contact, and sexual coercion

Women who have been sexually assaulted should be tested for HIV at _____ to _____ weeks and at _____ months.

4-6, 3

sexual assault

Any sexual act performed on another person without that person's consent. The use of force is not necessary to the definition. Instead, a threat of force or the victim's inability to consent is sufficient.

Transgender

Having a gender identity that is not concordant with one's natal sex.

gender expression

How masculine or feminine characteristics is manifested in an individual.

incest

sexual relations between people classed as being too closely related to marry each other

sexual behavior

Actual romantic and/or sexual activities that a person engages in, which may be congruent with the person's stated attraction or may differ. A woman who has sex with other women, for example, may not identify as homosexual.

When implementing an intervention for a client experiencing intimate partner violence, what is the primary goal? The client will regain a sense of control in life. The client will be removed from the abusive relationship. The client will be able to care for oneself. The client will be able to stand up to the abuser.

The client will regain a sense of control in life.

rape

a crime of forcing another person to have sexual intercourse with their offender against their will

sane nurse

a nurse that has been trained to deal with sexual assault victims

intimate partner violence (IPV)

any actual or threatened psychological, sexual, or physical harm of one current or past partner by the other; 4/5 victums are women - there is often trauma bonding that occurs, economic instability and fear of what would happen if they left allowing IPV to reoccur

The nurse who counsels clients who suffer from intimate partner violence (IPV) understands that IPV can come in which form(s) of abuse? Select all that apply. emotional abuse spiritual abuse sexual abuse physical abuse financial abuse

emotional abuse physical abuse financial abuse sexual abuse

adhedonia

the inability to experience pleasure

Rohypnol

the most common sedative drug used in rape

a victum of sexual assault is ideally evaluated _________ hours after crime

72

sex

A biologic term relating to the physiologic, hormonal, and anatomic characteristics of a person.

gender identity

A person's self-concept of the person's gender as male, female, or other. Gender identity may or may not align with the person's natal sex.

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.

why is pregnancy immediately following bariatric surgery contraindicated?

low birth weight and miscarriage risk

CAGE questionnaire

a screening questionnaire that assesses for addiction and substance abuse

A 16-year-old girl is brought to the clinic by her mother because she has not had a menstrual period for the past 8 months. Which findings might alert the nurse to the possibility that anorexia nervosa may be contributing to the client's amenorrhea? Select all that apply. hyperthermia bradycardia hypotension reduced subcutaneous fat evidence of secondary sex characteristics

bradycardia hypotension reduced subcutaneous fat Hypothermia, bradycardia, hypotension, and reduced subcutaneous fat may be observed in women with amenorrhea with anorexia nervosa as the contributing factor. Evidence of secondary sex characteristics would be a normal finding for a girl of this age.

A woman is being cared for in the emergency department following a sexual assault. In addition to the physical exam and collection of the rape kit, what sexually transmitted infection (STI) testing should the nurse prepare to collect during the initial examination visit? Chlamydia, trichomoniasis, gonorrhea and hepatitis B HIV, hepatitis B, chlamydia, and human papillomavirus HIV, hepatitis C, hepatitis A, and gonorrhea Syphilis, HIV, chlamydia, and herpes simplex

Chlamydia, trichomoniasis, gonorrhea and hepatitis B When testing for STIs following a sexual assault the following tests should be done: chlamydia, gonorrhea, trichomoniasis, syphilis, HIV and hepatitis B. These should also be rechecked 1 to 2 weeks after the assault. HIV testing includes three different test times after the assault. Checking for human papillomavirus should be done as a visual examination for warts 1 to 2 months after a sexual assault. Hepatitis C testing is not done routinely after a sexual assault, nor is testing for the herpes simplex virus.

A nurse is working with a client who is anticipating the possibility of leaving a relationship with intimate partner violence. In helping the client make the decision to leave or to stay in the abusive situation, which action would be most important for the nurse to take? Ensure the client understands the behaviors inherent in the cycle of intimate partner violence. Explain to the client how to develop a safety plan for leaving the relationship. Assist the client in finding a new apartment and a new job. Suggest that the client legally change his or her name and move out of state.

Explain to the client how to develop a safety plan for leaving the relationship. In situations of intimate partner violence, leaving an abuser may result in harm or death to the victim. Therefore, teaching the client how to develop a safety plan for leaving the relationship is of the most importance. Although survivors also need information about the cycle of intimate partner violence, this is not the priority when discussing the decision to leave. The nurse should provide information on available resources to assist the client in finding shelter and employment, as well as legal services, government benefits, and support networks. The nurse should not perform these actions for the client.

While admitting a client, the client states, "Our budget is tight. My spouse determines which spending is appropriate and okay for us since I am not allowed a job." Which action by the nurse is appropriate at this time?

Notify the client's health care provider of the client's situation.

panic attack

a type of anxiety that consists of a discrete event involving fear and somatic symptoms that occurs without warning

anorexia nervosa

an eating disorder in which one engages in caloric restriction below their requirements for weight maintenance, has a profound fear and anxiety about being overweight, and has a distorted perception of body weight; classified in accordance with patients BMI; often comorbid with many other anxiety and depression related disorders

bulimia nervosa

an eating disorder that consists of binge eating with inapropriate compensatory behaviors such as purging, laxative use, diuertic use, or excessive exercise at least weekly for 3 months often presents with erosion of dental enamel, tachycardia, hypotension, xerosis (dry skin), and swelling of the parotid glands