Answer Key to Lesson 6 - Substance Abuse and Battering - Case Study PDF

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Substance abuse and battering lesson 6 answer key...

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ANSWER KEY TO LESSON 6 – SUBSTANCE ABUSE/BATTERING Learning Objectives: 1. 2. 3. 4. 5.

Assess and plan for a substance-abusing woman with a term pregnancy. Discuss the statistics related to battering. List characteristics of battered women. Explore the myths and facts regarding battering. Identify the nurse’s role in regard to battered women.

In this lesson you will assess and plan care for pregnant women experiencing intimate partner violence and abusing substances. Patients: Dorothy Grant and Laura Wilson TEXTBOOK READING: Chapter 5 – Nursing Care of Women with Complications During Pregnancy 1. Complete the table below with information regarding Laura Wilson’s use of alcohol and recreational drugs. SUBSTANCE Tobacco Alcohol Marijuana Crack cocaine

REPORTED USE Smoke 10 to 20 cigarettes per day Drinks none to several beers per week Smokes a few times per week Smokes occasionally, from none to several times per week

2. Laura Wilson’s chart indicates that she has used cocaine. Which complications are linked to the use of this substance? (Select all that apply). _____ Placental perfusion abnormalities ___X_ Addiction of the newborn _____ Hypotension _____ Low birth weight ___X_ Fetal anomalies ___X_ Preterm labor 3. Laura Wilson’s chart indicates that she smokes cigarettes. Which complications are associated with this practice? Select all that apply. ___X_ Fetal growth restriction _____ Newborn nicotine addiction ___X_ Placental perfusion abnormalities _____ Fetal anomalies _____ Hyperemesis 4. Mental retardation in children has been linked to which behavior(s)? Select all that apply. _____ Tobacco use in pregnancy. ___X_ Alcohol use in pregnancy. _____ Marijuana use in pregnancy. _____ Cocaine use in pregnancy. ___X_ Dilantin use in pregnancy. _____ Lithium use in pregnancy. 5. How might Laura Wilson’s drug use affect the baby? Both marijuana and cocaine cross the placenta. Babies exposed to cocaine can have long-term growth and development problems. Even if the baby is not born addicted, if the mother is actively using, she may be less able to respond to the baby’s needs. Also, drug use puts Laura Wilson’s own health at risk. Lesson 6 – Nursing Care of Women with Complications During Pregnancy: Substance Abuse/Battering

6. Assume that you are the nurse caring for Laura Wilson today. Which interventions dealing with her drug use would be most appropriate at this time? Select all that apply. ___X_ Talking with Laura Wilson in a manner that conveys caring and concern. _____ Urging Laura Wilson to begin a drug treatment program today. _____ Explaining to Laura Wilson that she may lose custody of her baby if her drug use continues. ___X_ Involving other members of the health care team in Laura Wilson’s care. 7. After birth, Laura Wilson’s baby will need to be closely assessed for fetal alcohol syndrome. Which manifestations may be associated with this condition? Select all that apply. ___X_ Microcephaly _____ Thickened upper lip _____ Sharp facial features ___X_ Flat nasal bridge ___X_ Small palpebral (eye) fissures 8. Review the characteristics of battered women in your textbook. Battering occurs in __ ALL_ ethnic groups and at __ALL_ social levels. 9. What is the reality of Dorothy Grant’s situation after reviewing her records, and how does that correlate with the textbook reading? Dorothy Grant is in a very dangerous abusive relationship in which the violence has escalated during this pregnancy (this is a repeated escalation). However, up to this point, she has been hopeful that things would improve. 10. What are the greatest concerns for Dorothy Grant at this time? Care for her children, resources after the baby is born, and protecting herself from her husband. 11. Battered women share many characteristics. Compare the following list of characteristics with Dorothy Grant’s situation. For each characteristic listed, write YES or NO to indicate whether or not it applies to Dorothy grant. For all YES answers, provide a rationale to explain how that characteristic applies to her. Textbook Characteristics of Battered Women Financially dependent Few resources/support system Blame themselves for what has taken place State they are not “good enough” Bonding occurs out of fear and helplessness Low self-esteem History of domestic violence in their family Fear societal rejection Strong nurturing, yielding personality Tolerate control from others easily Attempt to avoid arousing anger in the abuser Deliberate/repeated physical or sexual assault

If/How each characteristic applies to Dorothy Grant Yes. Husband is sole provider Yes. Her sister is the only support Yes. She states that if she hadn’t gotten pregnant, then this wouldn’t have happened Yes. She states that she has no opportunity for job-related skills Yes. Strong loyalty to her husband as dictated through the sanctity of marriage as taught at her church Yes. She says she can’t please her husband. She sees herself as a wife and mother and has no perception of herself as an individual Yes. Her father was abusive to her mother Yes. She says her loyalty lies with her husband and church. Her church supports the sanctity of marriage Yes. She sees herself as a wife and mother and has no perception of herself as an individual Yes. She states, “My husband is the boss – he makes the decisions.” Her husband will not allow any form of birth control Yes. When the husband is around, she tries to keep the kids quiet Yes. She has been admitted to the hospital for blunt abdominal trauma; states that she has been forced to have sex.

12. What is the time period of greatest danger for the battered woman? When she leaves the abuser. Lesson 6 – Nursing Care of Women with Complications During Pregnancy: Substance Abuse/Battering

13. Indicate whether each statement is true or false. a. _True_ Battering often escalates or begins during pregnancy. b. _True_ Dorothy Grant’s husband blames her for the pregnancy. c. _False_ Dorothy Grant stays in the relationship because she likes to be beaten and deliberately provokes the attacks on occasion. 14. What nursing care plan diagnosis are appropriate for Dorothy Grant’s current life situation? • Hopelessness related to prolonged exposure to physical, mental abuse • Deficient knowledge related to phenomenon of battering, cycle of violence, and community resources • Ineffective individual and family coping related to persistence of victim-abuser relationship • Injury related to battering episode • Situational low self-esteem related to continuing victim-abuser relationship 15. Members of what other discipline have been contacted or consulted and will ensure continuity of care for Dorothy Grant as it relates to her abuse? Social worker and psychiatric mental health care worker 16. What is your responsibility, as a nurse, for reporting battering? Domestic violence is considered a crime in all states (although the level of crime varies). Nurses must be knowledgeable about the reporting requirements of the state in which they work. Abuse of children must be reported to appropriate authorities. 17. What resources are available in your area for women who are experiencing battering? Answers will vary depending on location/state.

Lesson 6 – Nursing Care of Women with Complications During Pregnancy: Substance Abuse/Battering...