womens health

WOMEN’S HEALTH, DOMESTIC VIOLENCE, & HUMAN TRAFFICKING

Readings

  • Nursing Health Promotion OER

    • Chapter 2: Section 2.4

    • Chapter 6: Section 6.3

    • Chapter 8: Section 8.10

    • Chapter 18: Sections 18.4, 18.14, 18.17

    • Chapter 19: Section 19.11

NCLEX BLUEPRINT OBJECTIVES

  • Management of Care

    • Maintain client confidentiality and privacy

    • Practice in a manner consistent with the nurses' code of ethics

    • Report client conditions as required by law

  • Safety and Infection Control

    • Protect client from injury

  • Health Promotion and Maintenance

    • Assess and educate clients about health risks based on family, population, and community

    • Educate clients about the prevention and treatment of high-risk behaviors

    • Educate clients about preventative care and health maintenance recommendations

    • Perform comprehensive health assessments

  • Reduction of Risk Potential

    • Perform focused assessments

  • Psychosocial Integrity

    • Assess client for abuse or neglect and report, intervene, and/or escalate

    • Assess the potential for violence and use safety precautions

    • Recognize non-verbal cues to physical and/or psychological stressors

WOMEN’S HEALTH PROMOTION, SCREENINGS AND DISORDERS

Health Screenings

  • Definition: Screenings are a form of secondary prevention to identify disease in early stages. They can help identify disease before patients experience signs or symptoms.

  • Source: The U.S. Preventive Services Task Force makes evidence-based recommendations about screening services.

    • Current recommendations can be found here: https://www.uspreventiveservicestaskforce.org/uspstf/topicsearchresults?category%5B%5D=18&searchterm=

  • Recommended Screenings Include:

    • HIV

    • Sexually Transmitted Infections

    • Cancers of the breast and cervix

Breast Health

  • Body Awareness: Self-breast awareness and exams. Being aware of how breasts normally look and feel.

    • Inspection and palpation for fibrocystic breast changes.

    • Characteristics: Lumpiness or nodules, occasionally painful; Caused by hormonal changes; Most common in women aged 20-50 years old.

    • Risk Factors: Excess dairy fat, caffeine, or nicotine.

    • Testing: Exam, Mammogram, ultrasound, biopsy

    • Treatment: Avoid risks, NSAIDs.

Breast Cancer

  • Warning Signs:

    • The American Cancer Society recommends yearly mammograms starting at age 45.

    • Several treatment modalities are usually used in combination.

    • Surgery, medical oncologists, radiation oncologists

  • Mammograms:

    • The U.S. Preventative Services Taskforce recommends a mammogram every 2 years for average risk women ages 40-74.

Cervical Cancer

  • Causes: Most often caused by Human papillomavirus (HPV).

  • Importance of Early Detection: Early detection and treatment are crucial.

Other Reproductive System Disorders

  • Abnormal Vaginal Bleeding

  • Bacterial Vaginosis: Higher risk for STIs.

  • Endometriosis

  • Ovarian Cysts

  • Pelvic Inflammatory Disease (PID)

  • Infertility: Causes and Treatment.

Menopause

  • Perimenopause: Transitional period leading up to menopause.

  • Menopause: Cessation of menstrual periods for 12 consecutive months marking the end of a woman's reproductive years.

  • Symptoms: Changes affecting body systems.

  • Treatments: Options for symptom reduction.

DOMESTIC VIOLENCE (INTIMATE PARTNER VIOLENCE)

  • Definition: Significant public health issue.

  • Statistics: 41% of women and 26% of men report physical or sexual violence or stalking by an intimate partner during their lifetime.

  • Consequences: Often results in injury or death; can contribute to other acute and chronic physical and mental health disorders.

  • Types/Behaviors:

    • Physical Violence

    • Sexual Violence

    • Stalking

    • Psychological Aggression

  • Contributing Factors to Domestic Violence (DV):

    • Childhood experiences

    • Male dominance in the family

    • Marital conflict

    • Unemployment or low socioeconomic status

    • Traditional masculinity or hypermasculinity

  • Duluth Model: Community-based program addressing IPV utilizing the Power and Control Wheel.

  • Cycle of Violence Phases:

    • Calm Phase

    • Tension-Building Phase

    • Altercation

    • Reconciliation Phase

NURSING MANAGEMENT OF DOMESTIC VIOLENCE

  • Considerations:

    • Victims of violence may enter the healthcare system in various ways.

  • Key Steps: Screen, assess, diagnose, plan, implement & promote health.

    • Acknowledge, support, allow time, anticipate needs, respect wishes, assist, educate.

    • Emphasize that it is NOT their fault.

    • Develop an Exit Plan.

REPORTING DOMESTIC VIOLENCE: OHIO LAW

  • Domestic Violence Definition: As defined by the Ohio Revised Code 2919.25, domestic violence is a criminal offense.

  • Reporting Requirements:

    • Ohio does not have an explicit law requiring healthcare providers to report suspected domestic violence.

    • Healthcare providers should contact law enforcement at the patient’s request.

    • If the victim presents with felony-level injuries (e.g., gunshot wounds, stabbings, second- or third-degree burns, or other serious injuries), they are required to report these injuries to law enforcement.

SEXUAL ASSAULT (RAPE)

  • Definition: Unwanted touch or penetration without consent.

  • Perpetrators: Rapists can be unknown, a family member, spouse, friend, or acquaintance.

  • Immunity: No one is immune to sexual assault.

  • Risk Factors:

    • Younger than age 25

    • Prior assault experience

    • Being a lesbian or transgender person

    • Military personnel

    • Homelessness

    • Physical/mental disability

    • Substance use (drugs and alcohol)

Common Myths about Sexual Assault (Rape)

  • Only certain types of women are raped.

  • Men rape women due to biological roles in nature.

  • Women who party hard, drink, and do drugs are setting themselves up for sexual assault.

  • If a woman relaxes, it will be over soon.

  • A rapist is easy to spot.

  • Women lie about rape.

  • Fighting back only incites the rapist to violence.

SEXUAL ASSAULT (RAPE) NURSING CARE

  • Sexual Assault Response Team (SART)

  • Forensic Nurse Examiner (FNE)

  • Sexual Assault Nurse Examiner (SANE)

  • Nursing Care Responsibilities:

    • Evaluate and treat injuries.

    • Conduct prompt examinations.

    • Provide emotional support.

    • Advocate for the victim.

    • Provide prophylaxis for STIs.

    • Assess pregnancy risk.

    • Discuss treatment options.

    • Arrange for follow-up care (physical and emotional).

HUMAN TRAFFICKING

  • Definition of Human Sex Trafficking: Obtaining a person through force for the purpose of commercial sex.

  • High-risk Populations:

    • Females, particularly those who are young, have limited education, engage in drug use, live in poverty, have a history of abuse, or who are runaways.

Signs of Trafficking

  • Evidence of being controlled.

  • Providing vague answers about situations.

  • Discrepancies in reported injuries.

  • Delayed seeking of treatment.

  • Symptoms of depression and substance abuse.

  • Recurring STIs.

  • Genital or rectal trauma.

  • Repeat miscarriages or abortions.

HUMAN TRAFFICKING STATISTICS FOR OHIO

  • For more information, visit:

    • https://humantraffickinghotline.org/state/ohio

    • https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/sexual-assault-and-domestic-violence-prevention-program/human-trafficking