NUR 211 Final Exam 2

NUR 211 Final Exam 2

• Cycle of Domestic Violence

Answer

• Build-up phase

tension

• Stand-over phase

Answer control/ fear

• Honeymoon Phase

Answer enmeshment, denial of previous difficulties

• Profile of Abuser

Answer

• Strong feelings of inadequacy.

• From violent homes where abuse was seen/ experienced.

• Abuser is threatened by victim's independence, victim is seen as property.
• HIGHEST incidence in ETOH and cocaine abuse.

• Family domains assessment

Answer

• Management

hierarchy w/in family.

• Communication members are free to express emotions. 1 / 4

• Emotional- Support

value affection vs. conflict/ anger.

• Socialization fam. models and teach social skills.

• Boundaries

barriers that protect and enhance integrity of individuals.

• Presentation of Abuse

Answer

• accidental discovery of injury.
• mult. injuries at various stages.
• no Hx offered/ contradictory Hx.
• inconsistent w/ stage of dev.
• suspicious attitude btw parent/ child.

• Non-accidental bruises

Answer

• Infants

face & butt.

• Children upper arms (defense), trunk, front of thighs, sides of face, ears, neck, genitalia,

stomach & butt.

*** may be marked/ shaped.

• Non-accidental burns

Answer

• Location 2 / 4

butt, btw legs, ankles, wrists, palms, soles.

• symmetrical vs. "splash"

• full thickness to muscle/ bone

• older, neglected, infected wounds.

• shape of an instrument.
• numerous stages of healing.

• Infant abuse injuries

Answer Subdural hematomas r/t shaken bb syndrome

• seen in <24mo, mostly at 6mo.
• s/s irritability, lethargy, disinclination to eat.
• inc. ICP vomiting, seizures, stupor coma.

Retinal hemorrhage r/t shaken bb syndrome.

• Internal organ injuries

Answer injuries below the diaphragm w/o external bruising r/t abd. ability to absorb trauma.

*** 2nd most common cause of death in child abuse.

• Anorexic Assessment

Answer

• Obtain baseline wt.

• Hydration status skin, labs= albumin, kidney fxn.), hematuria, proteinuria.

• Cardiac fxn rapid re-feeding, hypotension, bradycardia, anemia, peripheral edema from

hypoalbuminia, exercise intolerance.

• Integumentary hypothermia, laguna, gray cast, fragile/ dry skin. 3 / 4

• Reproductive amenorrhea may lead to infertility.

• Mood depression r/t decreased thyroid fxn. and lack of building blocks for NT.

• Musculoskeletal hypocalcemia, osteopenia, osteoporosis r/t decreased protein intake leads to

muscle wasting.

• GI constipation, cavities, oral lesions r/t poor nutrition.

• Socialization w/d from family/ relationships, decreased social activities.

• Bulimic Assessment

Answer

• Renal extended hypovolemia w/ e. imbalances --> renal failure, hematuria, proteinuria.

• Cardiac

1.) E. imbalances - hypokalemia, hypomagnesia, hyponatremia --> dys- rhythmias. 2.) Hypovolemia --> syncope. 3.) Cardiomyopathy r/t IPECAC intoxica- tion.

• Neuro seizures r/t electrolytes.

• GI erosion of enamel r/t vomiting & cavities, normal wt., esophagitis, Mallory Weiss tears (tear

btw esop. & stomach), gastric dilation/ rupture, rectal prolapse, D/C.

• Sialadeuosis swelling of salivary glands may lead to infection.

• Integumentary Russell's sign

• Cognitive/ Behavior distortions, ppl pleasing, extreme shame, denial of anger, rejection,

surface happy but depressed, impulsive (stealing).

***Alexithymia difficulty naming/ expressing emotion.

• Considerations for ADHD meds

Answer

• Cardiac palpitations
• / 4