Sexual trauma or physical abuse

1-What are the most important factors for the RN to assess when dealing with a female
refuge who is exhibiting flashbacks from trauma, especially sexual trauma or physical


The important factors that should be assessed by RN when dealing with patients who exhibits
flashbacks of trauma are the specific event details and qualitative traumatic experiences. This
helps shape the psychological responses. RN should also assess behavioural patterns that
depict psychological distress, health problems associated with the trauma, altered self-esteem
and self-image due to cultural rejection (Kee, Hayes, & McCuistion, 2015). These are
manifested by increased passivity, self-harm, emotional dysregulations, eating habits,
sleeping pattern and cognitive distortions. The patient might present increased heartbeat,
profuse diaphoresis, extreme anxiety, nausea, and hypervigilance and racing thoughts. The
patient may seem to have difficulty in concentrating or maintaining awareness of the current

physical condition. It is important to screen for further violence and provide moral and
physical support where needs be (Heavey, 2014).

2- Describe the cultural considerations and language barriers the RN will need to
address to foster therapeutic communication for the female refugee.
To improve eradicate communication barriers, the RN should note down and respond to
nonverbal and verbal communication cues that will ensure that patient communicates
effectively with the healthcare providers. For English-non speaking patients, it is important to
have an interpreter. However, it is important to consult with the patient as some may not want
to have an interpreter present due to confidential concerns (Kee, Hayes, & McCuistion,
The RN must remain cultural competent as much as possible. For example, some community
will not allow member of opposite sex to touch them. In most cultural, removing clothes in
front of a stranger is a taboo. Others will were ornaments that are associated with spiritual
protection. The patient beliefs and values must be protected. In addition, the RN should
assure the patient that their information is confidential. For patients with fears of attending to
clinic visits, the healthcare provider should break the process into steps so as to make it
manageable to the patient and to establish rapport and trusting relationship with the patient
(Kee, Hayes, & McCuistion, 2015).

3- List common triggers for this population and describe how the RN can assist to
decrease the effects.
The RN should remain vigilant on common triggers that a patient can experience during their
healthcare visits. These include issues such as medication and medical reagents scents in the
exam room, presence of health apparatus such as speculums, biopsy equipment, and

retractors. In some cases, particular dates of the year can be challenging to many survivors.
To decrease these effects, the RN must create a good rapport with the patient by listening to
their worries. This helps the RN asses the patients feeling and to identify the areas that needs
support and counselling (Kee, Hayes, & McCuistion, 2015).
Provide two nursing diagnosis statements (each statement must include an actual
nursing diagnosis, related factor and as evidenced by) that might apply to a refugee
client experiencing trauma flashbacks (Kee, Hayes, & McCuistion, 2015).

  1. Impaired adjustment (poor coping abilities) related to depression associated with trauma
    flashback experiences
  2. Altered nutrition (lower than the body requirements) related to decreased oral intake
    associated with difficulty self-feeding as a result of impaired mobility

Heavey, E. (2014). Female refugees: Sensitive care needed. Nursing, 44(5), 28-35.
Kee, J., Hayes, E., & McCuistion, L. (2015). Pharmacology: A nursing process approach
(8th ed.). Philadelphia, PA: Elsevier.