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MENTAL HEALTH (NURS 2547) WEEK 4 2025-2026|
QUESTIONS AND ANSWERS|100% VERIFIED
what two things are key aspects for practising effectively as a nurse self-awareness and self-care Interpersonal violence intentional use of physcial force, power, threatened or actual against oneself, someone, group, community, that either result in or has a high likelyhood of resulting in injury, death, psychological harm.. If a patient has a history of violence what do you notice physcially? fidgity, walking, bruises, scars, etc. If a patient has a history of violence what do you notice emotionally? sad, widthdrawn, doesnt want to talk, etc..
Neurobiologic Theory
- neurologic conditions (TBI), seizure disorder, dementia
- chemical imbalances in neurotransmitters cause loss of emotional control (depression, schizophrenia)
- substance use (alchohol, other drugs) Interpersonal theory cause of violence lies in the personality of the abuser due to:
- lack of self-regulation
- poor problem solving skills
- unrealistic demands for time and attention
- possessive tendencies over partners Social theory
- family stress theory
- social learning theory Domestic violence
d) sexual b) neglect What can happen in school/any place to a child? bullying If a child is bullied, what behaviour? widthdrawn, avoiding school, not having friends, may have agression (way of coping), might have bruises, harm, etc.. Signs of physical abuse any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained Signs of sexual abuse fearful behaviour (nightmare, depression, unusual fears, attempts to run away), abdominal pain, bedwetting, UTI, etc..
Signs of emotional abuse sudden change in self-confidence, headaches, or stomach aches with no medical cause, abnormal fears, increased nightmares, or attempts to run away Signs of neglect failure to gain weight (espeically in infants), desperately affectionate behaviour, voracious appetite, stealing food Impact of abuse on a growing child physical system
- stress during childhood may produce an activiation of the hypothalamic-pituritary-axis which influences the hypthalamic- pituitary-gondaldal axis, affecting sexualization and puberty
- irreversible brain damage
- decrease volume of prefrontal cortex, affects behaviour, balancing emotions, and perception Impact of abuse on a growing child belief system
Long term Psychological Effects on Child abuse •Depression, PTSD (60-85% of children & adults who experienced abuse suffer from PTSD) Anxiety Disorders, Personality Disorders, Phobias, Dissociation, depersonalization (common defense mechanisms expressed by victims to cope with the abuse) •Eating Disorders: Anorexia, Bulimia, Binging •Substance Abuse •Suicide, self harm • Homelessness Long Term Social Effect on Child Abuse
- Problems in interpersonal relationships • Re-victimization• Altered sexual Functioning• Difficulties with parenting
- Under-achievement, educationally & vocationally• Conduct disorder is nine times more likely to occur in abused teens as in the non-abused population Child abuse victims often cope with the exposure to abuse by becoming abusers later in life & mimicking learned behavior. Look for possible signs of abuse: Physical (bruises, scratches, pain, fractures)• Emotional (may include social withdrawal, emotional problems or depression • Abnormal sexualized type behaviour for the age group (flirting, overly sexual) •
Stealing or begging for food• Dressed inappropriately for the weather or appear unkept As a nurse it is our duty to ______ any signs of abuse and.... report any signs of abuse, consult with the local child protection society or children's aid society right away, even if unsure. It is the legal responsibility of nurses to report child abuse to children's aid society when suspected. Nursing Interventions
- Adopt a nonthreatening, non- judgmental relationship with parents Understand that children do not want to betray their parents Provide a complete physical, mental & social assessment of child. Failing to ask assessment questions & incomplete assessment can be seen as professional misconduct Ensure that proper procedure is followed, & evidence is collected Use of dolls might help child tell his or her story of how "accident" happened Keep accurate & detailed records of incident: verbatim statement of who caused the injury when it occurred, a body map to indicate size, Report child abuse to CAS or contact supervisor to implement appropriate reporting
Spiritual etiology of family violence Spiritual distress T/F Violence is multigenerational True What can be some risk factors for abuse assessment
- Rigid belief system about human relations
- Previous history of abuse &/or neglect
- Isolation• Poverty• Presence of a disability • Pregnancy Nursing Implications
- Ensure that medical attention is provided to client
- Set up interview in private & ensure confidentiality
- Assess in nonthreatening manner information concerning sexual abuse
- Encourage client to talk about the battering incident without interruptions
- Assess for level of violence in the home
- Ask how client is coping with the children in the home
- Assess if clients has a safe place to go when violence is escalating. If no, include a list of shelters or safe houses with other written information
- Identify if client is interested in pressing charges • Advise & support• Report abuse as per organization policy• Trauma informed Care Safety Planning for Client An emergency escape plan focuses on things a client will need if they have to escape quickly to find safety
- Arrange to make photocopies of relevant & important documents, such as passports, birth certificates, health cards
- Keep wallet, purse & keys close by, emergency cash & a picture of partner/spouse
- Keep a list of numbers for friends, shelters & help lines• Make arrangements with friends to stay if able• Teach children to learn on how to call the police• Create a code word with children &/or friends to know to call for help • Creating a Safety Plan (Peel Committee Against Woman Abuse) Types of crisis
Phase 4 What is phase 1 of crisis Increased feelings of anxiety, use of problem-solving techniques & defence mechanism Phase 2 of crisis Phase 2: anxiety continues to rise, feelings of extreme discomfort, trial & error solutions Phase 4 of crisis overwhelming anxiety resulting in personality disorganization, depression, confusion, transition to mental health emergency state Phase 3 of crisis Phase 3: severe panic, withdrawal & flight
If a person has panic anxiety, how should the nurse respond/talk to them? they should just stay with them, even without saying anything helps Which part of ADPIE is this in: Promote a sense of safety by assessing the person's potential for suicide or homicide Assess the person's perception of the precipitating event Assess the person's situational supports Assess the person's coping skills Self- assessment assessment Which part of ADPIE is this in: How much has this crisis affected the person's life? How is the state of disequilibrium affecting significant people in the person's life? Planning
d) try to talk to them, validate their feelings, and try to be with them Role of Nurse during a crisis is to
- Duty to provide care• Involvement across all aspects of disaster planning • Mental Health First Aid trauma experience of violence & victimization including sexual abuse, physical abuse, severe neglect, loss, domestic violence &/or the witnessing of violence, terrorism or disasters traumatic stressor any event (or events) that may cause or threaten death, serious injury or sexual violence to an individual, a close family member, or a close friend Collective trauma
refers to instances in which a significant proportion of any given social group - based on political, racial, religious, cultural, or other factors - are collectively exposed to a traumatic event Historical trauma is the process by which a social group is affected by the consequences of multiple, collectively experienced adversities across time that outweighs group resiliency factors, become cumulative, & are carried forward to subsequent generations such that the trauma may be considered as part of a single trajectory. Residential schools is an example of what trauma? historical or collective? can be both, maybe mainly historical due to the past Responses to Collective Trauma
- Creating public awareness• Training of frontline workers• Encouraging traditional practices & rituals• Promoting positive family & common relationships & processes • Rehabilitation & networking with other organizations
Trauma & Violence Informed Care (TVIC) Extends the principles of TIC to ensure it encompasses experiences of violence & acknowledges the traumatic effects of abuse on the individual with a focus on their safety & recovery
- Recognized both interpersonal & structural forms of violence as causes of trauma
- Does not focus on encouraging clients to disclose details of trauma they have experienced or on treating their trauma symptoms, instead, fosters an environment where all clients feel safe & there is less possibility they will be traumatized again. Key Principles of TIC Trauma awareness• Create Safety & Trust• Provide an opportunity for choice, collaboration & connection • Look at Trauma through the eyes of the patient• Recovery from Trauma is Possible how to create Safety & Trust Consider the barriers to engagement:
- Patients who have had negative previous hospitalization are likely to mistrust clinicians during current hospitalization
Provide alternatives to restraint:• It is more therapeutic to take more time to LISTEN to de-escalate the patient as opposed applying restraints Listen to patients & attend to their immediate needs:
- If a patient is reporting pain, or withdrawal symptoms, instead of waiting for physician to come, assess the patient, call to report your assessment findings & obtain relevant orders Allow a support person to be present if patient feels that it would be helpful Consistently explain why & what you are doing before doing something. Recognize the importance of physical & social boundaries. Follow through with promises made to the patient in a timely manner. Acknowledge & take responsibility for miscommunication.Use a professional tone that conveys genuine care & concerns Use open-ended questions to understand what physical & emotional safety means to the patient
- What have you found helpful to calm down & get focused when you are feeling anxious?
- What makes it worse? The patient says that "I want to go back to my husband", the nurse knows that there has been abuse what should the nurse do: a) do nothing about it and just let her go
