Trauma of Violence

marissatalley9's version from 2015-06-29 23:39


Question Answer
1. impactinitial disorganization, initial reaction- fear, anger, rage, shame, guilt, helplessness, eating, sleep disturbances, may have amnesia, nightmares, flashbacks
2. recoilstruggle to adapt, danger over-emotional stress continues, may look & act normal, fantasies of revenge, need support- may want to talk about what happened
3. reorganizationwant pt to move to and through, takes months to years, regaining a sense of control, reviewing & organizing what happened, "why me", blame self/others
domestic abuse/violencepattern of behavior that dominates controls, lowers self-esteem, takes away freedom of choice
acts of commissionemotional & physical abuse
acts of omissionneglect
1. tension building- perpetratorincreased expectations, blames, doesn't try to control behaviors, verbal & minor physical abuse increases, afraid she will leave, keeps captive/more possessive, misinterprets her withdrawal as rejection
1. tension building- victimnurturing, compliant, tries to please, denies, alters behavior, blames work/alcohol, scared, may call for help
2. acute battering phase- perpetratortrigger events occur, usually in private, threatens more harm if she tries to get help, tries to justify, minimizes severity, stress is relieved
2. acute battering phase- victimmay provoke to get it over w/, call for help if afraid of being killed, police presence = fear of more abuse, anxious, ashamed, fatigued, depressed, lies about cause of injury if seeks help
3. honeymoon- perpetratorloving, charming, begs for forgiveness, makes promises, truly believes won't do again, feels he "taught her a lesson", preys on her guilt to keep her trapped
3. honeymoon- vicitimsees as "real one", wants to believe won't happen again, believes in the relationship
the abuserproduct of abusive home, learned from witnessing/experiencing, perfectionist/rigid, dual personality- views victim as property, low self-esteem, stress/family tension- single parent home, financial strain, unemployment
the victimexperiences- loss of trust, loss of control, relationship to family & friends disturbed, emotional reactions= denial, fear, anger, powerlessness, depression, sense of failure, guilt
why the victim staysfear of life, children life, lack of support, religious/cultural beliefs, lack financial independence
clinical manifestationsmay present w/ health problems- anxiety, insomnia, GI, physical injury, unexplained injury- various stages of healing; assessment- obtain good hx; prioritize critical & serious injuries, social diagnosis
RADAR- RRoutinely inquire about violence
RADAR- A Ask direct questions
RADAR- DDocument findings
RADAR- AAssess safety
RADAR- RReview options and referrals
outcome idpatient & caregiver free & safe from harm, develop escape plan, recognize vicitim isn't to blame
outcome id patient- develop SAFE or ESCAPE plan, develop sense of self-esteem
outcome idcaregiver- another staff member in room, safe-zone b/w abuser & door, demo concern- tell pt not to blame- confirm self-worth
mandated reporting vs. confidentialitycan not contact law enforcement or other agencies against victims will unless wounds have been inflicted by specific weapons ex. firearms/knives
mandated reportingelder and child abuse
silent victimschildren of abused parents
children of abused parentswitness, abused/inadvertenly injured, suffer, increased risk for alcohol, drug or other problems
child abuse/neglectphysical abuse/injury, emotional abuse, neglect- physical, emotional; sexual abuse- molestation, incest
assessment for sexual abuse in childrenverbal reports, sexual awareness & vocab beyond age appropriate, sexual expression w/ toys, pregnant at less that 15yo, perineal, vaginal, anal inflammation, vague abd pain or acting ou, vaginal tears/anal fissures, STD, increased anxiety, sleep disturbances, tics, nail biting, stuttering, change in school performance, fear of being alone w/ specific adult
elder abuse physical, verbal, psyhological, financial, exploitation, neglct/self-neglect, sexual abuse, causes- caregiver stress, care exceeds capacity, mental illness
elder abusephysical- infliction of physical harm/injury, verbal, psychological, financial, neglct, self-neglect- unable to provide self-care, sexual abuse
sexual assaultrape- act of aggression- not passion, use of force against persons will
date raperapist known to victim, marital rape, statutory rape
sexual assualt manner treated important for future well-being, crisis intervention begins when pt enters health care facility
forensic nurse examinerobtains hx, performs physical exam, collects evidence, document, work w/ police & attorneys- testify, must be unbiased, requires specialized training