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Health Assessment Chapter 7 Domestic Violence Assessment
Terms in this set (29)
Child emotional abuse
any pattern of behavior that harms a child's emotional development or sense of self worth. it includes frequent belittling, rejection, threats, and withholding love and support.
failure to provide for a child's basic needs (physical, educational, medical, and emotional)
child physical abuse
physical injury due to punching, beating, kicking, biting, burning, shaking, or otherwise harming a child Even if the parent or caregiver did not intend to harm the child, such acts are considered abuse when done purposefully
Child sexual abuse
includes fondling a child's genitals, incest, penetration, rape, sodomy, indecent exposure, and commercial exploitation through prostitution or the production or pornographic materials
willful infliction of force that results in bodily harm, pain, and or impairment on a person age 65 years or older. Examples include pushing, slapping, hitting, shaking, burning, and rough handling
Elder neglect (physical)
physical harm (actual or potential) to person age 65 years or older because of failure to provide for the person's well being. Examples include inadequate feeding and hydration unsanitary living conditions, and poor personal hygiene.
Intimate partner violence (IPV)
physical and or sexual violence (use of physical force) or threat of such violence, also psychological. emotional abuse and/ or coercive tactics when there has been prior physical and or sexual violence between spouses or non marital partners (dating, boyfriend girlfriend) or former spouses or non marital partners)
mandatory reporting of abuse
a specified group of people (eg health care providers) is required by law to report abuse (of a specified nature against specified people) to a governmental agency
(eg protective services, the police)
infliction of emotional/mental anguish by humiliation, coercion, and threats and/or lack of social stimulation. Examples include yelling, threats of harm, threats of withholding basic medical and.or personal care, and leaving the person alone for long periods.
Routine universal screening for intimate partner violence
asking all adult patients (usually female patients) each time they are in the health care systems, no matter what their problem or concern, whether they have experienced IPV
most common physical health problems that result from intimate partner violence
blunt force injury is the most common form of IPV
-when skin tears it's called a laceration
-when a sharp instrument goes through tissue its an incision
most common mental health problems that result from IPV
-problems with substance abuse
abuse vs neglect
abuse are violent acts that could result in injury or pain, impairment or disease;
neglect is failure to provide basic needs and/ or services
commonly used screening questions for IPV
-when you and your partner argue, are you afraid of him?
-does your partner try to control you?
-has your partner ever slapped, kicked, bit , physically hurt you?
-when you and your partner argue, do they emotionally abuse you?
-has your partner ever forced you into sex?
commonly used screening questions for older adult abuse
-has anyone ever physically hurt you?
-are you alone a lot?
-are you afraid of anyone at home or who enters your home?
-have you ever signed any documents you didn't understand?
-has anyone taken things that were yours without asking?
-has anyone touched you inappropriately?
routine universal screening vs indicator based screening
routine universal screening asks all women each time they come in the health car facility if they are being abused; indicator based screening is when there has been a sign that there is IPV going on
bruising in children and how it relates to their developmental level
when children start walking bruising is common on bony prominences. However, bruising on hands, feet, and buttocks can be alarming. In children younger than 4, bruising on torso, ears, and neck raise concern. Any bruise that takes the shape of an object is alarming. If a child is non mobile then bruising raises concern.
important elements of the child's medical history when assessing for suspected child maltreatment
-previous hospitalizations of injuries
-chronic medical conditions
-does the child take medication that causes bruising
-history of repeated hospital visits
-delay in seeking care for anything other than minor injury
-history of substance abuse in the home
-methods of discipline in the home
long term consequences of child maltreatment
severe forms of maltreatment can lead to death or long term disability such as mental retardation, blindness and physical disability.
risk factors that contribute to child maltreatment
-social isolation of families
-parents history of domestic abuse
-lack of family cohesion
-substance abuse in family
-young single nonbiological parents
abused women develop more ________ problems.
Chronic; such as neurologic, gastrointestinal, and gynecologic disorders and chronic pain.
older adults develop_________.
bleeding, localized infections, cardiac complications, sexually transmitted diseases, dehydration, and malnutrition
children can develop_________.
long term physical, psychologic, emotional, social, and cognitive dysfunction.
Abuse Assessment Screen
can be used to screen for IPV
-assess how recent and how serious the abuse was
-convey a sense of concern
-emphasize that it's not the woman's fault
-convey the message that help is availabe
Nine question screen
-assesses elderly patients who are cognitively intact
-red flags of abuse are physical findings that do not match the history
If a child is verbal...
Obtain a history AWAY from caretakers and use open ended questions or spontaneous statements
-complete head to toe
-describe physical findings using correct basic medical forensic terminology
-describe bruising specifically and photograph it
-obtain specimens for baseline lab tests if needed
Documentation of IPV and elder abuse
-must include detailed nonbiased progress notes, injury maps, and photographs
-include verbatim statements by the victim
-if needed, include obscenities and curses in the verbatim documentation
For a woman suspected of IPV...
-assess risk of homicide using Danger Assessment
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