Question

You are interviewing a 25-year-old woman who is being seen for a general physical exam. Her husband insists that he come into the room with the patient. You notice several bruises on the patient's arm in various stages of healing.When you inquire about the bruises, the patient gives you a vague answer and the husband says she is just accident prone. What should you do?

Answer 1

Vague answer of patient and interruption by husband shows suspected case of physical abuse.

• Nurse should firstly tell the suspected abuser which looks her husband in this to leave the room .
• Ask the patient regarding her bruises in absence of suspected abuser , better to have a one of colleague as witness the conversation.
• Provide calm , comforting environment and approach the patient with care and concern
• Head to toe physical examination should be done , looking for sign of abuse.
• Thorough documentation and description of physical findings as well as patient's behaviour , non verbal expression and behaviour and statements of suspected abuser should also be noted
• Notify the supervisior depending on workplace and also should notify law enforcement as soon as possible no matter patient wants or not as nurse may require to report suspicious injury to law enforcement .
• Advise support group to patient also offer to connect victims of counselling services as patient sometimes fall in vicious cycle of abuse and become unable to come out of it and need support from group councelling.

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