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Chapter 19
Sexual Assault
Sexual assault
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Act of violence not sex and results in severe &
long term trauma
Committed in context of unequal power in order
to demonstrate dominance & control
Encompasses: rape, date rape, acquaintance
rape, marital rape, molestation, incest, sexual
assault of elderly
No mandate currently to report unless it involves
abuse of minor or elderly
Prevalency and comorbidity
Usually committed by men against women
but can be vice versa
 1 in 10 rape survivors are male
 One of the most underreported crimes
 Aside from physical trauma of raper, risk of
sexually transmitted disease, HIV,
pregnancy and psychological sequelae
occur
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Cultural considerations
Cultural or societal factors play a part in
forming attitudes; women's inferiority, male
superiority, sexual entitlement
 Military-sexual assaults women resulting
from gender inequality along with norms
that support male dominance are a
concern
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Theory
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Person vulnerable to sexual assault
 Occurs within all age groups, genders, cultures and
socioeconomic backgrounds
Gender: 78% women, 22% men
 Age: 50% female before age 12
 Older adults: most often by adult male children
 History of sexual violence
 Drug and alcohol use
 High risk sexual behavior/ poverty
 Ethnicity and culture
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Perpetrator of sexual assault
 Biological: neurotransmitter dysfunction
 Psychological: antisocial, personality disorders & history of
Application of nursing theory
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Assessment
 Treatment
sought in ER: institutional protocol-use of
rape kits
 Assessment Guidelines
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Diagnosis
 Rape-trauma
syndrome
 The acute phase: cognitive, affective & behavioral
 The Long Term Phase: re-experience trauma,
social withdrawal, avoidance behavioral, increased
psychological arousal characteristics, fears and
phobias
Application of nursing theory
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Outcomes Identification
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Short Term Goals
Long Term Goals
Implementation
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Follow sexual assault protocol in ER procedure manual
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Pharmacological, Biological & Integrative Therapies
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ER: Treatment should address physical injuries, pregnancy prophylaxis,
and sexually transmitted diseases
Pharmacology/ Psychotherapy/ Crisis Counseling
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Follow-up Care
Community Based Supports
Therapy for Rapists
Evaluation