Rape Trauma Syndrome

Rape Trauma Syndrome

(_)Actual (_) Potential

Related To:
[Check those that apply]
Somatic Response:
(_) Gastrointestinal irritability (N/V, anorexia)
(_) Genitourinary discomfort (pain, puritus)
(_) Skeletal muscle tension (spasm, pain)
(_) Other:___________________________
___________________________________
Sexual responses:
(_) Mistrust of men (if victim is woman)
(_) Change in sexual behavior
Other:_____________________________
__________________________________
Psychological responses:
(_) Denial
(_) Emotional shock
(_) Anger
(_) Fear
(_) Guilt
(_) Panic on seeing assailant or scene of attack
(_) Other:_____________________________
____________________________________
____________________________________

 

As evidenced by:
[Check those that apply]
Major:
(
Must be present)
(_) Reports or evidence of sexual asault
Minor:
(
May be present)
If the victim is a child, parent(s) may experience similar responses:
Acute Phase:
  • Somatic responses: Gastro-intestnal irritability (N/V, anorexia) Genitourinary discomfort (pain, pruritus) Skeletal muscle tension (spasm, pain)
  • Psychological responses: Denial, emotional shock, anger, fear of being alone or that the rapist will return [a child victim will fear punishment, repercussions, abandonment, rejection] guilt, panic on seeing assailant or scene of attack
  • Sexual responses: Mistrust of men (if victim is a woman), change in sexual behavior.

Long term phase:

  • Any response of the acute phase may continue if resolution does not occur.
  • Psychological responses: Phobias, nightmares, or sleep disturbances

 

Date &
Sign.
Plan and Outcome
[Check those that apply]
Target
Date:
Nursing Interventions
[Check those that apply]
Date
Achieved:
  The patient will:

(_) Experience decreased symptoms of:

 

(_) Discuss assult.

(_) Express feelings concerning the assault and the treatment.

(_) Identify members of support system and utilize them appropriately.

(_) Return to pre-crisis level of functioning.

(_) Other:

 

  (_) Assess for psychological responses:
  • Phobias
  • Denial
  • Anger
  • Depression
  • Guilt
  • Other:

 

(_) Inspect urine and external genitalia for bleeding.

(_) Observe patient's behavior carefully and record objective data.

(_) Promote trusting relationship.

(_) Provide crisis counseling within one hour of rape trauma event.

(_) Help patient meet personal needs of:
________________________

(_) Allow patient to express feelings.

(_) Discuss with patient previous coping mechanisms.

(_) Explore with patient her/his strengths and resources.

(_) Offer feedback to patient on feelings verbalized.

(_) Explore sexual concerns with patient.

(_) Initiate health teaching and referrals as necessary.

(_) Other:________________
________________________
________________________
________________________

 

 

__________________________
Patient/Significant other signature

 

__________________________
RN signature