Question

Violence against women is a serious health problem in our communities. Describe the nurses’ role in caring for women who have been victimized by abuse of any kind. Discuss specific interventions related to caring for women who have been abused.

Answer 1

Nursing Assessment of individuals experiencing post traumatic stress attends to biological , psychological, emotional and environmental(physical and social) as well as coping resources. In particular a nurse should explore changes in the individual's life

Biological Domain

Biological data are essential for analyzing an individual's physical response to stress, coping efforts and adaptation. The information comes form the health history, physical examination and diagnostic testing . Nurses should pay paticular attention to:

Signs and symptoms of symphathetic arousal

• Alterations in vegetative functions(e.g: appetite and eating patterns, sleep,energy level, sexual activity
• Chronic illness or conditions with a strong stress component (e.g: hypertension, migraine, chronic painsyndromes, irritable bowel syndrome)
• Evidence of immune system suppression (e.g: frequent infections)
• Physical appearance (e.g: deficits in grooming and hygiene, nonverbal indications of muscle tension, anxiety or depression)
• Alterations in activity and exercise pattern

Social Domain

Social assessment includes identification of person's social network. The nurse shold elicit the following information

Size and extent of the network, both relatives and non-relatives and the length and quality of the relationship

Functions the network serves (e.g: intimacy, social integration, nurturance,reassurance of worth, guidance and advise , access to new contacts)

Nursing Interventions

• Assign the same staff as often as possible. Use a non-threatening matter of fact but friendly approach. Respect the client's wishes regarding interaction with individuals of opposite gender at this time
• Be consistent and keep all promises and convey an attitude of unconditional acceptance
• Stay with the client during fashbacks and nightmares. Offer reassurance of safety and security that these symptoms are not uncommon following a trauma of the magnitude he or she has experienced
• Obtain an accurate history from significant others about the trauma and the client's specific response
• Encourage the client to talk about the trauma at his or her own pace. Provide a non-threatening private environment and include a significant other if a client wishes
• Discuss coping strategies used in response to the trauma at his or her own pace. Determine those that have been most helpful and discuss alternate strategies for the future. Include available support systems, including religious and cultural influences. Identify maladaptive coping strategies such as substance use or psychosomatic responses, and practice more adaptive coping strategies for possible future trauma responses
• Assist the individual to try to comprehend the trauma if possible. Discuss feelings of vulnerability and the individual's place following the trauma