護理師評估高齡長者是否遭受虐待,下列哪些發現應通報相關單位?(選所有適合的)
A nurse is assessing a client for potential elder abuse. Which findings should the nurse report to the appropriate authorities? (Select all that apply.)
- AUnexplained bruising on the upper arms✓ 正解上臂有不明原因的瘀傷
- BInconsistent history provided by the caregiver and the client✓ 正解照護者與病人提供的病史不一致
- CPoor personal hygiene and soiled clothing✓ 正解個人衛生不良且衣物髒污
- DThe client refuses to make eye contact with the caregiver✓ 正解病人拒絕與照護者進行眼神接觸
- EThe client has a history of dementia病人有失智症病史
核心概念:識別與通報疑似長者虐待(Elder Abuse)的跡象。 為何正確答案對: A. 無法解釋的瘀傷(Unexplained bruising)可能表示物理虐待,特別是若瘀傷位置不尋常(如手臂上方、軀幹)或數量多,且與病人聲稱的事件不符。 B. 照護者和病人說法不一致(Inconsistent history provided by the caregiver and the client)可能暗示照護者在隱瞞真相或操弄病人,需要進一步調查。 C. 個人衛生不良與衣物髒污(Poor personal hygiene and soiled clothing)若與病人能力不符,可能表示疏忽照顧(Neglect),是虐待的一種形式。 D. 病人迴避與照護者眼神接觸(The client refuses to make eye contact with the caregiver)可能表示恐懼、不信任或受到脅迫,是心理虐待或脅迫的潛在跡象。 為何其他選項錯: E. 失智症病史(The client has a history of dementia)本身不是虐待的證據,但失智症病人因認知功能受損,更容易成為虐待的受害者。因此,失智症病史是評估其他虐待跡象時需要考慮的風險因素,但本身不構成通報的直接理由。
Unexplained bruising, inconsistent histories between the client and caregiver, poor hygiene, and avoidance behaviors such as refusing eye contact are all red flags indicating potential physical, emotional, or neglectful abuse. These findings warrant immediate reporting to authorities, whereas a history of dementia is a risk factor but not direct evidence of abuse.