Question

A 30 y/o woman Sally presents to the Emergency Department with a complaint of sexual assault by a co-worker in her office. She has no facial or body trauma, bruising or lacerations. She is withdrawn, crying and relates feeling very guilty about coming into the hospital but is afraid of getting pregnant. They had begun dating a week ago, but she never believed this man would become so aggressive. After greeting her in the room the nurse must begin an assessment. You must develop a rapport with this woman – please begin. After the initial history a physical will take place, please request the best individual to perform this task. Sally asks you what will happen, can you explain this to her? Please provide detailed attention for this client

**develop a rapport*

**physical assessment**

**additional testing**

Answer 1

Techniques to develop rapport:

• Initial make her calm and greet her with preferred name.
• Make her to focus on your words.
• Introduce yourself to the victim that is nurse,physician or any other health care professional.
• Aim for her attitude of respectful,calm with in the boundaries of patient culture.
• Give time to her because she was frightened and experienced fear.
• Maintain eye contact with victim as much as you can.
• Be non judgemental,reassuring and understand the feeling of the victim to recount her experiences.

Physical assessment:

Specific details include:

• Type of sustained injuries at mouth,mammary glands,and at rectum area etc
• Any bleeding from the patient at private parts that helps to assess the transmission of hepatitis and AIDS.
• Detail description of attack on victim.
• Assailant's use of weapons,aggression or violent behaviour.
• Description of criminal or attacker.

Additional testing:

• Sperm testing
• Colposcopy should help to visualize the injuries at the genital areas.
• If the victim has amnesia at the time of attack drug screening for flunitrazepam because is it is a sedative and hypnotic drug and gamma hydroxybutyrate (anaestic).

Follow up tests:

• At 6 weeks:Gonorrhea,chlamydial infection and syphilis.
• At 12 weeks:HIV infection
• At 24 weeks: Syphilis,hepatitis