NUR 211 Final Exam 2
1. Cycle of Domestic Violence
Answer
1. Build-up phase
tension
2. Stand-over phase
Answer
control/ fear
3. Honeymoon Phase
Answer
enmeshment, denial of previous difficulties
2. 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.
3. Family domains assessment
Answer
- Management
hierarchy w/in family.
- Communication members are free to express emotions.
,- Emotional- Support
value affection vs. conflict/ anger.
- Socialization fam. models and teach social skills.
- Boundaries
barriers that protect and enhance integrity of individuals.
4. 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.
5. 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.
6. Non-accidental burns
Answer
- Location
,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.
7. 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.
8. 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.
9. 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.
, - 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.
10. 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.
11. Considerations for ADHD meds
Answer
- Cardiac palpitations