Mental Health Nursing 2019 video 22 (Ch 32)



all right so continue on with chapter 32 we're gonna talk about family and community violence so let's first talk about some of the risk factors that places an individual at higher risk for abuse or violence these include being a female partner being pregnant a history of violence within the family substance abuse whether that's like alcohol or drugs children under 3 years old are at higher risk for abuse physically or mentally disabled children are at higher risk as well as children from unwanted pregnancies older adults are at higher risk for abuse due to their poor health and dependence on caregivers an individual who is trying to leave an abusive situation would be at higher risk for violence or abuse its violence and abuse is more common within family groups as opposed to with strangers it's more likely to occur with someone you know versus someone you don't know and violence and abuse occurs across all economic and education levels in society so let's talk about the three phases in the cycle of violence between intimate partners so the first phase is the tension building phase this is where there are some minor episodes of anger there's probably some verbal abuse that's taking place and the vulnerable person in that relationship is probably very tense and then in the second phase that is the acute battering phase this is where serious abuse takes place and then the third phase is the like the honeymoon phase this is where the abuser becomes loving and they're sorry for the behavior they may promise to change maybe they bring home flowers and are like I'm really sorry I'm gonna change but usually what occurs is that after the honeymoon phase the cycle begins again with periods of escalation and de-escalation so that honeymoon phase is usually not like a legit I'm sorry I'm gonna stop it usually just starts again so in terms of the types of violence that can occur you first have physical violence this is where physical harm is directed towards another whether that be a child an intimate partner or an older adult then you have sexual violence this is where there is sexual contact without consent and then you can have a neglect which is a form of violence if this is where you fail to provide for the physical care or the emotional care of another so this includes things like food shelter clean clothes education and health care and then finally we have economic maltreatment this is where there is failure to provide for the needs of a vulnerable person despite the fact that funds are available so if you have an older person and they have a bank account and that money should be used to help take care of them and perhaps that caregiver is using that money instead to go gambling or do something else and they're not providing for the needs of the vulnerable person that is an example of economic maltreatment all right so let's talk about some of the signs of abuse in children so with infants you always want to be assessing for signs of shaken baby syndrome so this can include respiratory distress bulging fontanel's and increase in head circumference also you should never see bruising on infants under six months of age because if you think about it they're kind of laying there they're not up walking around and falling and getting into mischief so really if you see bruising under six months of age then that is a warning sign that abuse is taking place when you're looking at preschoolers and older children you should look for the location of bruising on their body so bruising on arms and legs is somewhat expected because again they're they're walking around they're falling they're playing they're getting into mischief but if you see bruising on the abdomen the back the buttocks this is more these are more unusual locations for the bruising and that way be a warning sign also if the child has bruised these bruises in different states of healing on their body that should be a warning sign as well as forearm spiral fractures which can indicate someone is like you know squeezing and twisting a child's arm if you see the presence of multiple fractures that's a warning sign if the child has small round burns this can be indicative of burns from like cigarettes which of course is abuse and then if there are burns that cover the child's hands or their feet from possible immersion in boiling water this is definitely a red flag for all of these things if you have any suspicions that someone is being abused whether it's a child an older adult you know an intimate partner in a relationship you are obligated as a nurse to report that suspicion so if you are asked a question about this on a TIR NCLEX it's not your responsibility to find out definitively if there's definitely abuse occurring if you suspect there is abuse occurring you must report and and that's it you don't need to prove anything you don't need me do it in like interrogate anyone you just need to report that suspicion okay so that's it for chapter 32 that I want to go over and we will pick it up with chapter 33 in my next video Thanks

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