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Nursing 4 Exam 1
Ethical and Legal Issues
| Question | Answer |
|---|---|
| types of admission | voluntary and involuntary (commitment)-emergency |
| involuntary commitment | hospitalization against one's will |
| criteria for involuntary commitment | dangerous to self or others, unable to provide for basic needs |
| judicial hearing | specific period |
| emergency basis for involuntary commitment | crisis center but judge has to make decision within 48 hrs |
| clients rights | refuse meds, least restrictive treatment, active participation in tx, tx, informed consent, communicate w/others |
| clients rights | confidentiality and right to privacy |
| federal rule | can not give out info that client is admitted to a psychiatric facility |
| exception of confidentiality and right to privacy | duty to warn/protect-protective privilege where public peril begins & client is child/minor |
| confidentiality is compromised when... | talking about pt other than tx team or where other can hear, clinical documentation seen by others, careless handling of medical info, limits of group or indiv therapy, compter generated info/technology |
| informed consent | geive enough info to make decision (purpose,pros,cons,s/e,alternatives), emergency situation-may be treated |
| restraints and seclusion | use to prevent physical injury, document-what was done to prevent use of the procedure, MD order-how often, emergencey?, close observation(1:1), documentation, false imprisonment |
| state law reporting | mandatory reporting of child & sexual abuse. |
| Failure to report | criminal penalty, civil liability |
| duty to disclose/protect | identified individuals who are threatened, staff |
| types of lawsuits that occur in psychiatric nursing | malpractice and negligence, breach of confidentialitiy, defamation of character (Libel, slander), Invasion of privacy, assault and battery, false imprisonment |
| nursing actions to avoid liability | repsond to the pt, educate the pt, comply w/standard of care, supervise care, adhere to nursing process, document, f/u |
| types of abuse | child abuse-homicide(1 of 5 leading cause of death), physical abuse, neglect, shaken baby syndrome(1/3 die, 1/3 brain damage), munchausen syndrome proxy, intimate partner violence, elder, abuse of pregnant women |
| assessment of child with physical abuse when you suspect the parent or caregiver | conflicting reports or unable to explain the injury, h/o harsh discipline, h/o abuse as a child |
| physical abuse assessment | hitting, slapping, severe beating; injuies-burns, bruises, broken bones diff stages of healing, black eye, etc. |
| neglect physical assessment | refusal/delay of caregiver to provide health care, inadequate supervision, expulsion from home, abandonment |
| neglect physical indicators | malnutrition, begs/steal food, infected sores, lacks appropritate clothing |
| neglect behavioral indicators | continued hunger, poor hygiene, unsupervised activities, poor school acitivities, etc. |
| neglect s/s when caregiver is suspected | indifferent, abuse alcohol/drugs, depressed |
| emotional neglect | failure to provide the child w/hope, love, and support to help develop healthy personality |
| physical indicators of sexual abuse | STD, UTI, nightmares, difficulty walking/sitting |
| behavioral indicators of sexual abuse | clinging attachment to parents, nightmares, unusual sexual knowledge, sexual abuse of others |
| implications fo sexually abused children | clinging attachment ot parents, impulse control/aggression, social isolation, sexual acting out, self-destructive behaviors, running away from home, falshbacks, nightmares |
| implications for sexually abused children | guilt and shame cause social isolation & alienation, powerlessness, rage(sometimes slef directed), self-blame leading to anxiety, depression and panic attacks |
| common characteristic of adult survivor of incest | lack of trust, low self-esteem, absence of pleasure w/sexual activity, promiscuity |
| types of abuse | adult, spouse, interpersonal |
| battering | repeated physical &/or sexual assault, intimate partner, coercive control |
| profile of battered victim | all ages, race, education, low self esteem, grew up in abusive homes |
| profile of the victimizer | low self esteem, pathologically jealous, presenting a "dual personality", limited coping skills, viewed spouse as "personal possession" |
| phase 1 cycle of battering | tension-building: men's frustration level increasing, women becomes nurturing,compliant, stay out of his way, minor battling, rationalizes for his behavior, assumes the guilt for the abuse, battering becomes more intense |
| phase 2 cycle of battering | acute battering incident: most violent and shortest |
| phase 3 cycle of battering | calm, loving, respite (honeymoon) batterer-extrememly loving and kind victim-believes he can change symbiotic relationship |
| why does he/she stay? | fear for their lives, lack of support network for leaving, religious belief, lack of financial independence |
| sexual assalut | date, marital and statutory rape |
| implications for rape | expressed response(fear,anger,anxiety) |
| compounded rape reaction | depression, suicide, drug addiction, psychosis |
| silent | tells nobody, anxiety is suppressed |
| fear of | future attacks and intimacy |
| self blame | limited decision making ability |
| which assessment data would raise suspicion that a 10 yr old client is a victim of abuse? | low self-esteem, poor eye contact, multiple scars, intense fear of nudity |
| the nurse understands that during the tension buildig phase of the cycle of abuse, victims may protect themselves by exhibiting which of the following behaviors? | attemp to nurture abuser |
| a client is caring for a pt who has experienced a h/o spousal abuse resulting in several fx's. the first prioritiy for the nurse is to: | assist the pt to devise a safety or escape plan |
Created by:
jbittner
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