Week 5 Discussion: Assessing for Family Violence (graded)

Sample Answer for Week 5 Discussion: Assessing for Family Violence (graded) Included After Question

Discussion

A 10-year-old child named Elizabeth is brought into the emergency department by her mother. The mother appears anxious but sits quietly next to her daughter in the waiting room. When called into the triage area, the mother gives a history of coming home from work to find Elizabeth sitting on the couch watching television. Elizabeth did not go to the door to greet her or look toward her when she said hello. The mother thought the daughter’s behavior was odd because she always greeted her at the door with a hug. As she approached Elizabeth, she noticed that she was clutching her right arm as if in pain. The mother asked what was wrong, but Elizabeth remained silent. Then she said “Nothing is wrong.” The father is sleeping upstairs. The mother gives a family history of having an alcoholic husband who usually drinks himself to sleep. She said he has abused Elizabeth physically and psychologically in the past, and she brought her to the emergency room because she fears he has hurt her. When Elizabeth is asked about the abuse she appears scared, insecure, and withdrawn.

1. What considerations should be made by the nurse, to provide a physically and emotionally safe environment for the interview and assessment of this client who has experienced domestic abuse?
2. In your response, include some special considerations that should be taken when interviewing a child.

A Sample Answer for the Assignment: Week 5 Discussion: Assessing for Family Violence (graded)

Title: Week 5 Discussion: Assessing for Family Violence (graded)

Weber states, the long-term consequences of child abuse and neglect, according to the Child Welfare Information Gateway (2013a), include: Physical: emotional conditions such as chronic fear, hypervigilance, impulsivity, psychological: isolation, fear, and an inability to trust—can translate into lifelong psychological consequences, including low self-esteem, depression, and relationship difficulties; behavioral: adolescent issues such as grade repetition, substance abuse, delinquency, truancy, or pregnancy, and sexual risk-taking; greater likelihood of being raped in adulthood; correlation with juvenile delinquency and adult criminality; abuse of alcohol and other drugs; greater likelihood to become abusive parents. (Page 163). Our goals as nurses are to assess immediately assess and detect abuse and refer to child protective service for close monitoring and removal from harmful situations of abuse. There are communicative approaches to use with Elizabeth who is only ten, and ongoing through the developmental stage of industry versus inferiority-task at this stage are developing social, physical, and learning skills with successful competence; therefore an unsuccessful result to Elizabeth’s situation is sense of inferiority; difficulty learning and working (Silvestri pg. 258).

Elizabeth needs to first be in a comfortable setting with the nurse and mother. Elizabeth’s mother is initially invited to demonstrate to Elizabeth the nurse’s purpose of interviewing her is not for intimidation or to elevate the stress. Simple questions through a physical assessment will be conducted to Elizabeth, and engage in conversations that encourage thinking, providing reassurance to help alleviate fears and anxieties, using clear terms, patience by the nurse to allow time for composure and privacy, and using photographs, books, dolls, and even videos to demonstrate and explore Elizabeth’s situation ( Silvestri 267). Thereafter of the physical assessment, the mother will be kindly asked to provide Elizabeth privacy, and assure the mother her child is safe, and the interview will stop at any point Elizabeth expresses so. With all these communication approaches, the nurse allows Elizabeth to be in a mental state to freely speak, where the nurse and Elizabeth find a trusting rapport, and the nurse is assessing within the trust. This approach can assist in intervening this potential psychological and physical abuse by Elizabeth’s father.

In the article of the Scandinavian Journal of Primary Health Care, it states from a database with general physicians reporting suspected abuse cases from that gut feeling “all groups discussed the gut feeling described as there is something wrong here and considered it a valuable diagnostic tool. In such cases, GPs got an uneasy feeling, while listening to complaints or observing a child, which put them on the alert. An odd symptom or unusual behaviour, such as a child behaving like ‘an unguided missile in my office’ [FG4,1] and the intimidating reaction of its parents might make GPs think there is something wrong.” (117).

References:

Stolper, Erik; Verdenius, Jan Paul; Dinant, Geert-Jan; van de Wiel, Margje June 2020. Scandinavian Journal of Primary Health Care. GPs’ suspicion of child abuse: how does it arise and what is the follow-up? 38(2): 117-123. (7p)

https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144636703&site=eds-live&scope=siteLinks to an external site.

 Silvestri, Linda Anne. (2011) Saunders comprehensive review for the NCLEX-RN examination /St. Louis, Mo.: Elsevier/Saunders

Weber, J.R. & Kelley, J.H. (2018). Health assessment in nursing (6th ed.). Wolters Kluwer.

5. Grading Rubric

Discussion Criteria	A (100%) Outstanding or highest level of performance	B (87%) Very good or high level of performance	C (76%) Competent or satisfactory level of performance	F (0) Poor or failing or unsatisfactory level of performance
Answers the initial graded threaded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points	Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts.16 points	Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts.14 points	Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts.12 points	Minimally addresses the initial discussion question(s) or does not address the initial question(s).0 points
Integrates evidence to support discussion. Sources are credited.* ( APA format not required) 12 points	Integrates evidence to support your discussion from:assigned readings** OR online lessons, ANDat least one outside scholarly source.***Sources are credited.*12 points	Integrates evidence to support discussion from:assigned readings OR online lesson.Sources are credited.*10 points	Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson.Sources are credited.*9 points	Does not integrate any evidence.0 points
Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points	Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion.14 points	Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion.12 points	Responds to a classmate and/or instructor but does not further the discussion.10 points	No response post to another student or instructor.0 points
Communicates in a professional manner. 8 points	Presents information using clear and concise language in an organized manner (minimal errors in English grammar, spelling, syntax, and punctuation).8 points	Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation).7 points	Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation).6 points	Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation).0 points
PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T.	0 points lostStudent posts an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.		-5 pointsStudent does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p . m. MT.
PARTICIPATION Total posts: Participates in the discussion thread at least three times on at least two different days.	0 points lostPosts in the discussion at least three times AND on two different days.		-5 pointsPosts fewer than three times OR does not participate on at least two different days.