A woman was in the emergency department with a bruised and broken leg.

A woman was in the emergency department with a bruised and broken leg. She explained that she had accidentally opened the car door on a trip and the door had blown back on her leg.

Her husband was very attentive, constantly asking the nurse to make his wife more comfortable. Which of the following actions should be taken by the nurse?
a.
Ask the husband to step out of the room while you get a urine specimen, and, after he leaves, ask the woman, “Have you ever been deliberately hurt by someone?”
b.
Call x-ray immediately, and prepare for the leg to have a cast applied.
c.
Put ice bags on the area until the leg can be repaired.
d.
Try to get an additional pain medication order from the physician.

ESSAYBID ANSWER

ANS: A
Abuse of women is often explained as accidental injury. Approximately 6% of visits made by women to emergency departments are for injuries that result from physical battering by their husbands, former husbands, boyfriends, or lovers. It is important for the nurse to understand the state laws related to reporting known or suspected domestic violence. The AMA and ANA advocate that all women should be assessed for intimate partner violence. Questions should be posed privately, in nonjudgmental specific terms (i.e., “Do you feel safe?” “Have you ever been hit, punched, slapped, or kicked?”) with follow-up questions if the woman responds “yes.” In this situation, with a questionable explanation for the injury and an overly attentive husband, it would be important to complete this assessment. This invention would be more important than calling for x-ray, applying ice, or administering additional pain medication.