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Substance Abuse and Violence

Terms in this set (36)

✯ Myths Surrounding Partner ______ and ______
▪︎ Battering is infrequent
⇢ About 1/3 of all women will experience some kind of abuse in their lifetime. 10% of all women will report this abuse.
▪︎ Abused women often provoke the abuse
⇢ 'She pushed him over the edge'. Gives permission to the abuser to act that way. We should all understand that we are all responsible for our own behavior. Even if somebody is being somewhat inappropriate, it does not allow someone to act abusively towards that person. Abused women are not provoking the abuse. It is up to the other person who is doing the abuse to act in a way that promotes diplomacy and self-control.
▪︎ Drugs and ETOH cause abuse
⇢ There are higher rates of abuse in situations with drugs and ETOH. However, this is not an excuse to abuse another person. We're all in control and responsible of our own behavior.
▪︎ Abused women can easily leave the situation
⇢ Easy for many people not in the relationship to tell them to leave. Woman may stay in an abusive situation due to finances (especially if they are dependent on the male), kids are involved (concerned about how it will effect them), love hate relationship with the abuser, and if she does leave what are the long term implications, She may feel that her safety is in jeopardy if she leaves now. Need to have a plan in place.
▪︎ Violence is a low income issue
⇢ Low income can lead to stress in a relationship. However, violence is something that can take place in any SES. Any age, culture, or race. Not just a low income issue. Low income patients may report it to hospital mores. Those with higher incomes can report it privately and take care of matters that way.
▪︎ Abused women are safe during pregnancy
⇢ Physical abuse is often aimed at the breast/torso area. Often times the abuser finds the pregnancy a threat. Not all of the attention is on him. This can be a time where abuse can be initiated or actually perpetrated (become worse).
✯ _______ __________: Nursing Assessment
▪︎ Respect, trust, and advocacy
⇢ Build a relationship with the patient. Going to respect her as a human being, ask her questions, and take her word for it. Don't want to push her too hard on this.
⇢ Build a relationship that has trust at the base of it, so that she feels that she can tell you the truth.
⇢ Going to advocate for her, her desires, and rights.
▪︎ Listen to her
⇢ Maker her feel heard and we'll believe what she says.
▪︎ Stress myths
⇢ Stress that she didn't do anything to make this happen. It is unacceptable behavior.
▪︎ Let her talk at her own speed
⇢ Not going to push her. Ask open ended questions. Be concerned and document things in her own words.
▪︎ May have conflicting feelings toward abuser
⇢ May be in the honeymoon period.
▪︎ Should she leave?
⇢ Want to make sure that she can leave safely and has a plan together.
▪︎ Signs of abuse:
⇢ Neuro signs
・Headaches, tension headaches, migraines, hearing loss, detached retinas
⇢ Gyn signs
・Reports of painful intercourses, frequent STIs, pelvic pain
⇢ OB signs
・Late prenatal care, recurrent therapeutic abortions, recurrent spontaneous abortions
⇢ GI signs
・IBS, feeling of a lump in the throat
⇢ Musculoskeletal signs
・Fibromyalgia, painful joints
⇢ Psychiatric Signs
・Panic, anxiety, mood disorders, substance abuse, eating disorders
⇢ Constitutional Signs
・Abrasions, sleep disturbances, appetite problems, decreased concentration, frequent use of tranquilizers
⇢ Trauma
・Injury to her female organs, accident histories (more than usual), having sexual trauma, history of frequent old fractures
⇢ Other Signs
・History of frequently missed appointments, neglected appearance, and the way she relates to HCP like lack of eye contact. See if she is not acting appropriately given the situation. Defensive injuries. Delayed reports of symptoms or seeking care for injuries way after the incident occurred.
✯ Sexual Violence Nursing Management: _______
▪︎ Many emergency departments have this type of specially trained nurse available to work with patients who have gone through sexual violence.
▪︎ Rape is a trauma and crime
⇢ We treat this physiologically, psychosocially, and legally it is a crime.
▪︎ Obtain history
▪︎ Prevention of STIs
⇢ Therapy will take place for this. Will often order prophylactic antibiotics to help prevent some STIs under these circumstances. Since gonorrhea, chlamydia, and some other STIs can be treated with antibiotics.
▪︎ Prevention of pregnancy
⇢ Emergency contraception may be ordered. It can be used pretty effectively 72-96 hours, depending on which form it is, after the incident.
▪︎ Collect evidence:
⇢ Clothes
・We'll label it. Presence of fluid or semen may be present. However, this does not indicate any sexual assault occurred. This is not up to nurses to decide. It's up to legal authority.
⇢ Swabs of fluid
・Or any secretions. Can be in the vaginal area or mouth as well. Often times there is sexual dysfunction on the part of the perpetrator. Sometimes they may use a condom and we may not find anything.
⇢ Hair and fingernail scrapings
・Looking for loose pubic hairs or potentially hairs that may have transferred. The woman's hair & any loose hairs will be collected for testing.
・If she was fighting the rape she may have tissue or cellular debris under her nail that belongs to the perpetrator. This can be helpful in identification.
⇢ Blood samples
・To see if there are any infections.
⇢ Urine samples
・If she was drugged what did they drug her with.
⇢ Photographs
・If there was any additional trauma. Need consent to do so.