Ch. 28: Child, Older Adult and Intimate Partner Violence
*Nurse’s role in reporting child abuse
*Risk factors for child & elder abuse
*Therapeutic responses to domestic violence victim
*Characteristics of abusing parents
Nurse’s Role in Reporting Child Abuse:
Identification:
Nurses play a crucial role in recognizing signs of child abuse or neglect during routine
assessments.
They need to be vigilant for indicators such as unexplained injuries, changes in behavior, or
inconsistent stories.
Documentation:
Accurate and thorough documentation of observations is essential for the reporting process.
This documentation may include detailed descriptions of injuries, statements from the child, and
any other relevant information.
Reporting:
Nurses are mandatory reporters in many jurisdictions, meaning they are legally obligated to
report suspected cases of child abuse to the appropriate authorities.
Reporting procedures may vary by location, so nurses must be familiar with local regulations.
Risk Factors for Child & Elder Abuse:
**Child Abuse**
Parental Stress: High levels of stress can contribute to frustration and the potential for abusive
behaviors.
Substance Abuse: Drug or alcohol abuse can impair judgment and increase the risk of abuse.
Mental Health Issues: Untreated mental health conditions may contribute to abusive behavior.
History of Abuse: Adults who were abused as children may be at a higher risk of becoming
abusers.
**Elder Abuse**
Caregiver Stress: Overwhelmed or stressed caregivers may be more prone to abusive behavior.
Dependency: Elders relying on others for care may be at risk.
Isolation: Elders who are socially isolated may be more vulnerable.
History of Violence: A history of violence within a family may increase the risk.
Therapeutic Responses to Domestic Violence Victims:
Safety Assessment: Nurses should assess the immediate safety of the victim and help develop a
safety plan.
Active Listening: Allow the victim to share their experiences without judgment.
Empowerment: Encourage the victim to make decisions about their safety and future.
Referral to Support Services: Connect the victim with local resources such as shelters,
counseling services, and legal support.
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Characteristics of Abusing Parents:
Aggression: Physically or verbally aggressive behavior toward the child or partner.
Impulsivity: Acting without thinking, leading to harmful behaviors.
Substance Abuse: Drug or alcohol abuse contributing to impaired judgment.
History of Abuse: Many abusers have a history of being abused themselves.
Lack of Coping Skills: Inability to manage stress and frustration appropriately.
Ch. 29: Sexual Assault
In cases of sexual assault, nursing interventions play a crucial role in providing
compassionate care to survivors and collecting forensic evidence. Here are some nursing
interventions and guidelines for collecting evidence:
Nursing Interventions:
Immediate Care and Safety:
Ensure the survivor's physical safety and well-being.
Provide a private, quiet, and secure environment.
Emotional Support:
Offer a non-judgmental and supportive environment.
Allow the survivor to share their experience at their own pace.
Informed Consent:
Explain the purpose of the forensic exam and obtain the survivor's informed consent.
Clearly communicate the voluntary nature of the examination.
1. Documentation
Document a detailed account of the survivor's statement.
Record any physical injuries, visible trauma, or signs of distress.
2. Forensic Evidence Collection:
Encourage the survivor not to shower, bathe, change clothes, or brush teeth until
after the forensic exam.
Collect evidence from the survivor's body, including swabs from relevant areas.
Collect clothing and personal belongings for evidence.
3. Medical Examination:
Conduct a thorough medical examination to assess and treat injuries.
Screen and treat for sexually transmitted infections (STIs) and pregnancy if
applicable.
Offer prophylactic treatment for certain infections, like HIV.
4. Psychosocial Support:
Provide information about available support services, such as counseling and
advocacy.
Discuss options for reporting the assault to law enforcement, respecting the
survivor's choices.
5. Referral and Follow-Up:
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