Violence

Intimate partner violence (IPV) is defined as

a pattern of assault and course of behaviors that may include physical injury, psychologic abuse, sexual assault, progressive social isolation, stalking, deprivation, intimidation, and threats between current or former partners of an intimate relationship, regardless of gender or marital status (CDC, 2014).

Societal and cultural risk factors for domestic violence

1. Poverty or unemployment 2.communities with inadequate resources or overcrowding. 3. social isolation of families 4. substance abuse 5. early parenthood 6. inadequate coping skills 7 family members with chronic health conditions.

psychological factors correlated with domestic violence

1. low self-esteem 2. poor problem-solving skills, 3. history of impulsive behavior 4. hypersensitivity 5. narcissism 6. personality traits "cause" abusiveness

Cycles of violence

1. tension building 2. acute battering 3. honeymoon stage

overindulgence results in

1.Lack of empathy 2. Social/emotional impairment 3. Obesity

A nurse is working with a married woman who has come to the emergency department several times with injuries that appear to be related to domestic violence. While talking with the nurse manager, the nurse expresses disgust that the woman keeps returning to the situation. What is the best response by the nurse manager? 1. "She must not have the financial resources to leave her husband." 2. "Most women try to leave about six times before they are successful." 3. "There's nothing the staff can do; people are free to choose their own lives." 4. "These women should be told how stupid they are to stay in that kind of situation."

2. Nurses who work with victims of partner abuse need to be supportive and patient. It takes time and several attempts for most victims to leave abusive relationships. It may or may not be true that the client does not have the financial resources to leave her husband; there is not enough information to support this conclusion. The staff can encourage the woman to make plans for addressing various potential events and provide information about social services and telephone help lines. Shaming women in this position will simply make them less likely to seek help.

A married female client has been referred to the mental health center because she is depressed. The nurse notices bruises on her upper arms and asks about them. After denying any problems, the client starts to cry and says, "He did not really mean to hurt me, but I hate for the kids to see this. I am so worried about them." What is the MOST crucial information for the nurse to determine? 1. the type and extent of abuse occurring in the family. 2. the potential of immediate danger to the client and her children. 3. the resources available to the client. 4. whether the client wants to be separated from her husband

2. The safety of the client and her children is the most immediate concern. If there is immediate danger, action must be taken to protect the. the other options can be discussed after the client's safety is assured.

A young child in whom sexual abuse is suspected says to the nurse, "Did I do something bad?" What is the most therapeutic reply by the nurse? 1."Who said you did something bad?" 2."What do you mean, 'something bad'?" 3."Do you think that you did something bad?" 4."Do you think that I think you did something bad?"

2."What do you mean, 'something bad'?"

Elder abuse

any knowing, intentional, or negligent act by a caregiver or any other person to an older adult; the act causes harm or serious risk of harm

A nurse is assessing a client who is being abused. The nurse should assess the client for which characteristics? Select all that apply. a. assertiveness b. self-blame c. alcohol abuse d. suicidal thoughts e. guilt

b, c, d, e The victims of abuse is usually compliant with the spouse and feels guilt, shame, and some responsibility for the battering. Self-blame, substance abuse, and suicidal thoughts and attempts are possible dysfunctional coping methods used by abuse victims. The victim of abuse is not likely to demonstrate assertiveness

When planning the care for a client who is being abused, which measure is MOST important to include? a. being compassionate and empathetic b. teaching the client about abuse and the cycle of violence c. explaining to the client about the client's personal and legal rights d helping the client develop a safety plan.

d. helping the client develop a safety plan. the client's safety, including the need to stay alive, is crucial Therefore, helping the client develop a safety plan is most important to include in the plan of care. Being empathetic, teaching about abuse, and explaining the person's rights are also important after safety is ensured.

Child abuse

deliberate action that is harmful to a child's physical, emotional, or sexual well-being

intergenerational violence theory

family violence purports that behavior are developed through role modeling, identification, and human interaction. Violence is an acceptable reaction to stress and become a behavioral norm.

emotional abuse

includes name calling, excessive criticism, ignoring accomplishments, yelling and swearing, mocking, isolation, locking the victim in a room, threats and intimidation, and denying abuse and blaming the victim.

An injured child is brought to the emergency department by the parents. While interviewing the parents, the nurse begins to suspect child abuse. Which parental behaviors might support this conclusion? Select all that apply. 1. Demonstrating concern for the injured child 2. Focusing on the child's role in sustaining the injury 3. Changing the story of how the child sustained the injury 4. Asking questions about the injury and the child's prognosis 5. Giving an explanation of how the injury occurred that is not consistent with the injury

2. Focusing on the child's role in sustaining the injury 3. Changing the story of how the child sustained the injury 5. Giving an explanation of how the injury occurred that is not consistent with the injury The child is often made the scapegoat in the situation; the parents blame the child because they have unrealistic expectations of the child. Discrepancies or inconsistencies in the history result from attempts to present a story that is not based in fact. Discrepancies between the parental explanation for the child's injuries and the physical findings or discrepancies in the history that each parent gives are common because the information that is being provided is not based in fact. Abusive parents usually do not ask questions about the injury or prognosis and demonstrate little or no interest in their child's well-being.

sexual abuse

Any sexual contact that is forced upon a person against his or her will

Which question demonstrates the nurse's understanding of the need to assess a client who has been physically abused for additional forms of trauma? 1. "What types of injuries have you received as a result of the physical abuse?" 2. "Do you know what triggers the physical abuse?" 3. "Did your abuser ever intimidate or threaten you with physical harm?" 4. "Can you tell me when the physical abuse began?"

"Can you tell me when the physical abuse began?" The physical damage caused by physical abuse is usually accompanied by emotional abuse. Emotional abuse includes threats and intimidation. The remaining options focus on the physical abuse/trauma.

Elder abuse red flags

-Fear of being alone with caregiver -Obvious malnutrition -Bedsores or skin lesions -Begging for food -Needs medical and/or dental care -Left unattended for long periods -Reports of abuse and neglect -Passive, withdrawn, and emotionless -Concern over finances and missing valuables

A client with suspected abuse describes her husband as a good man who works hard and provides well for his family. She does not work outside the home and states that she is proud to be a wife and mother just like her own mother. The nurse interprets the family pattern described by the client as BEST illustrating which characteristic of abusive families? 1. tight, impermeable boundaries. 2. unbalanced power ration 3. role sterotyping 4. dysfunctional feeling tone

3. The traditional and rigid gender roles described by the client are examples of role stereotyping. Impermeable boundaries, unbalanced power ratio, and dysfunctional feeling tone are also common in abusive families.

Child abuse assessment

Comprehensive history and physical examinations with documentation of findings Consult social worker/social services. Therapeutic communication in a quiet unhurried environment. Be open, nonjudgmental. Interview parent and child separately if possible. Obtain details from each person and compare. Observe behavior of child and parents behavior. Assess childs general appearance and behavior - is demeanor very different from parents description of child. Be aware of shaken baby s/s and cultural practices such as cupping or coining. Use figures and diagrams to document. Take photographs as directed to document location, nature and extent of injuries.

Interview guidelines for caregiver "do's"

Conduct a private interview. Be direct, honest, and professional. Be attentive and understanding. Inform the person if you must make a referral to Child Protective Services, and explain the process.

characteristics of abusive parent

History of violence, neglect, or emotional deprivation as a child Low self-esteem, depression Poor coping skills Social isolation (suspicious) Involved in a crisis situation— unemployment, divorce, financial difficulties Unrealistic expectations of a child Frequently uses harsh punishment

patriarchal theory

Male dominance in our political and economic structure enforces the differential status of men and women.

Diagnosis- outcome identification for child abuse

Safety, injury, and risk for injury are primary! The abuse should be ceased. Receive medical care. Notify the proper authorities. Provide safety.

Interview guidelines for caregiver "don'ts"

Try to "prove" accusations or demands. Display horror, anger, or disapproval of parents or situation. Place blame on or make judgments about the parent(s) or child.

A nurse is caring for a patient in the emergency department who has been a victim of intimate partner violence. What is most important for the nurse to include in the plan of care? a. Medication to calm the perpetrator of the violence b. A list of community resources c. A referral for self-defense training d. A referral to the victim's religious advisor

b. a list of community services

What behavioral findings correspond to intimate partner violence in young adolescents? Select all that apply. 1. Sexually acting out 2. Attempting suicide 3. Pattern of substance abuse 4. Fear of certain people or places 5. Preoccupation with others or one's own genitals

correct 2,3 Adolescent undergoing intimate partner violence may attempt suicide or have patterns of substance abuse. The behavioral findings in children undergoing sexual abuse include sexually acting out, fear of certain people or places, and a preoccupation with genitalia.

neglect

inconsistent provision of food, water, shelter, sanitation, or other basic needs. Can also be lack of schooling, medical care, or supervision and exposure to violent environments or substance abuse.

physical abuse

physical injury due to punching, beating, kicking, biting, burning, shaking, or otherwise harming a child; even if parent or caretaker did not intend harm, such acts are considered abuse when done purposefully

frustration-aggression hypothesis

when frustration is high in response to negative societal situations, frustrations may lead to aggression.