Family and Community Violence (ATI Ch. 32)
Terms in this set (29)
Violence risk factors
female, leaving a relationship (when they are most vulnerable), pregnancy, child ages three years or younger, unwanted pregnancy/physical disabled child, and older adult dependent on caregivers.
Cultural differences can influence whether the nurse assessment data is valid, how the client responds to interventions, and the appropriateness of nursing interactions with the client.
Violence can come from a human-made mass causality incident such as a _______ _______.
Natural disasters, such as hurricanes can cause mental health effects comparable to those caused by ______ ________ ________
human made violence
T/F A person who has a mental illness is no more likely to harm strangers than anyone else
most common within family groups, and most is aimed at family and friends rather than strangers. (maltreatment)
3 cycles of violence
tension-building, acute battering, honeymoon and periods of escalation and de-escalation phase.
tension building phase
first of the 3 cycles, the abuser has minor episodes of anger and may be verbally abusive and responsible for some minor physical violence. the victim is tense during this stage and tends to accept the blame for what is happening
acute battering phase
second of the 3 cycles, the tension becomes too much to bear and serious abuse takes place. the victim may try to cover up the injury or may GET HELP.
third of the 3 cycles, the situation defuses for a while after the violent episode. the abuser becomes loving, promises to change, and is sorry for the behavior. the victim wants to believe this and hopes for change. Eventually, the cycle begins again.
periods of escalation/de-escilation
this usually continues with shorter and shorter periods of time between the two. emotions for the abuse and victim, such as fear or anger, increase in intensity repeated episodes of violence lead to feeling of powerless. not one of the three cycles but falls under it.
must be complete and accurate and consist of subjective and objective data.
2 types of trauma specific interventions
Trauma Affect Regulation Guide for Education and Therapy (TARGET) and Trauma Recovery and Empowerment Model (TREM)
Trauma Affect Regulation Guide for Education and Therapy (TARGET)
provides trauma survivors with a therapeutic approach to healing while offering education about practical skills to manage emotions and the effect of memories on daily life.
Trauma Recovery and Empowerment Model (TREM)
a gender-specific model (TREM for female and M-TREM for male) designed to assist survivors of trauma, specifically physical or sexual trauma.
occurs when physical pain or harm is directed toward the following: infant or child, intimate partner, vulnerable adult
occurs when sexual contact takes place without consent, whether the vulnerable person is able or unable to give that consent
behavior that minimizes the individuals feelings or self worth or humiliates, threaten, or intimidates a family member
Failure to provide:
- physical care, such as feeding
- emotional care, interacting with a child or necessary stimulation
- necessary health or dental care
failure to provide the needs of a vulnerable person when adequate funds are available
Ex: unpaid bills resulting in disconnection of heat or electricity
Vulnerable person characteristics
- low self esteem
- feelings of helplessness
- hopelessness, powerlessness
- guilt and shame
- attempts to protect perpetrator and accept responsibility of abuse
- possible denial of severity of the situation and feelings of anger and terror
Infant assessment for abuse
- Shaken baby syndrome: leads to intracranial hemorrhage.
- Assess for respiratory distress, bulging fontanelles, and increase head circumference.
- Retinal hemorrhage may be present
- Any bruising on infant before the age of 6 months is suspicious.
Preschooler to adolescent assessment for abuse
- assess for bruising on abdomen, back, buttocks, arms and leg
- assess the mechanism of injury, may not be congruent with the physical appearance of injury
- be suspicious of bruises or welts that resemble shape of a belt buckle
- assess for burns; burns covering "glove" or "stocking" can indicate immersion into boiling water
- assess for fractures with unusual feathers (spiral fractures)
- assess for human bite marks
- assess head injuries
Older adults and other assessment for abuse
- assess for bruises, lacerations, abrasions, or fractures in which the physical appearance does not patch the history or mechanism of injury
Nursing interventions for child or vulnerable adult
- mandatory reporting of suspected or actual cases of abuse
- complete and accurate domination of subjective and objective data
Nursing history for abuse
- provide privacy
- be direct, honest, and professional
- use language client understands
- be understanding
- use open-ended questions
- inform the client if referral must be made to a child or adult protective services
Nursing interventions for community-wide or mass casualty incidents
- provide psychologic first aid
- make sure clients are physically and psychologically safe from harm
- reduce stress related manifestations
- provide interventions for rest and sleep
- depending on level of expertise, mental health nurses can provide assessment, consultation, therapeutic communication and support, triage, and psychological and physical care
Critical incident stress debriefing
crises intervention that assists those who experienced a traumatic event (death of a student, rescue workers after an earthquake)
- takes place in group meetings with a facilitatory who promotes a safe environment where there can be expression of thoughts and feelings
- the facilitator will acknowledge reactions, provide anticipatory guidance for manifestations, and provide referrals
- group can choose to meet on an ongoing basis or disband after resolution of crisis
Care after discharge
- help client develop safety plan
- identify behaviors and situations that might trigger violence
- provide info on safe places to live
- encourage participation in support groups
- use crisis intervention techniques to help resolve family or community situations where violence has been devastating
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