Student’s Name: 

Course & Year Level:  BSN & 3rd year

Semester & School Year: 2nd semester & 2021 - 2022

Date of Submission: April 05, 2022

Clinical Instructor: Dean. Henry Apolinar

Case Scenario: Raped

Cynthia is a 22-year-old college student who spent Sat urday afternoon with a group of friends at
the football game. Afterward, they were going to attend a few par ties to celebrate the victory.
Alcohol was served freely at these parties. At one party, Cynthia become separated from her
friends but started talking to Ron, whom she recognized from her English Lit course. They spent
the rest of the evening together, talking, dancing, and drink ing. She had had more drinks then
she was used to, as Ron kept bringing her more every time her glass was empty. At the end of the
night, Ron asked if she wanted him to drive her home. Her friends were staying longer at the
party.

When Ron and Cynthia arrived at her apartment, none of her roommates had returned yet, so she
asked Ron to come in. She was feeling a little tipsy and they began kissing. She could feel Ron
really getting excited. He began to try to remove her skirt, but she said, "No" and tried to move
away from him. She remembered him saying, "What's the matter with you? Are you a prude or
what?" She told him she had had a good time but didn't want to go further. He responded, "Come
on, you've been trying to turn me on all night. You want this as much as I do." He forced himself
on top of her and held his arm over her neck and raped her.

When her roommates return in about 1 hour, n thia is huddled in the corner of her room, seems
stunned, and is crying uncontrollably. She feels sick and confused. Did she do something to
cause this whole thing? She keeps asking herself whether she might not have gotten into that
situation had she not been a little tipsy. She is so confused.
CLINICAL VIGNETTE: RAPE
1.What are the possible assessment you can conduct for Ms. Cynthia?
 Every word spoken by a rape victim is delicate. We should keep our phrases as short
as possible and carefully develop them. Consent and privacy are essential.

 Physical Examination: Examine the body for any bruises or injuries. Bruises and
injuries are signs that the pt is resisting rainfall. (Specific locations include the mouth,
breasts, genitals, and the rectum.

 History: The following is a description of how the pt. got raped or assaulted (which
orifice was penetrated etc.)

 Mental Status: Examine the patient's level of awareness. Victims of rape frequently
have devastating experiences.

 Description Of Assailants: Aggression, threats, weapons, and aggressive behavior by

the assailant.

 Colposcopy: In the case of genital injuries.

 Laboratory Test: Pregnancy test to see if the patient is pregnant. is expecting a child.

 Vaginal Test: Is checked for trichomonas vaginitis and bacterial vaginosis as well.

 Laparoscopy: Determine the extent of the genital damage.

 Serologic Test: Test for syphilis, hepatitis b, and HIV.

 CBC Test: Is also necessary.

 Drug Screening: To determine if the pt. has been drugs.

2. What are the possible pieces of evidence that you can assess from Ms. Cynthia to prove she's
been raped?
 The physical examination should take place before the woman has washed, cleaned
her teeth, douched, changed her clothes, or had anything to drink in order to preserve
possible evidence. This may not be achievable because the woman may have done
some of these activities prior to seeking medical attention. If there isn't any, If there is
a report of oral sex, cleaning the mouth or drinking fluids can be allowed right away.
Fear, helplessness, shock, disbelief, shame, humiliation, and embarrassment are
common reactions among rape victims. After the party, Ron offered Cynthia a ride
 home, and when they arrived, they began intimating each other. When Cynthia
refused, Ron pushed himself on top of her, placed his arm over her head, and raped
her. Ms. Cynthia was hunched in the corner of her room, looking surprised and crying
hysterically. She also appeared unwell and perplexed. Ms. Cynthia has been blaming
herself for getting into this scenario, even though she is not inebriated.

3. What kind of treatment and intervention that you can best provide her?
 Victims of rape do best when they get prompt help and can communicate their fear
and wrath to family members, nurses, doctors, law enforcement authorities, and
doctors who believe in them. In Cythia's case, her pals are the ideal persons to
provide quick assistance. Health care providers, law enforcement officers, and the
general public must continue to be educated about rape and the needs of victims.
Cynthia will benefit from rape treatment programs. In addition to providing emotional
support, a nurse will be an important member of the team. As a nurse, do not press
Ms. Cynthia to attend an interview and examination; instead, give her the freedom to
make her own decision.
 It's critical to return as much control to the sufferer as possible. Allowing her to make
decisions about who to call, what to do next, and what she wants done, for example,
is one way to do so. It is the woman's responsibility. Whether or whether to press
charges and testify against the criminal is a decision that must be made. Treatment for
STDs such as chlamydia, gonorrhea, and syphilis is available as a preventative
measure. It is cost-effective to do so because many rape victims will not return for
definite test results for these diseases. HIV testing is highly recommended. In high-
risk locations, it is promoted. Ms. Cynthia will also be advised to use safe sex
practices until an HIV test is available, in order to prevent the infection from
spreading.

CLINICAL VIGNETTE: GRIEF

1. Kindly use the Kubler Ross theory of the Grieving Process in the scenario you've read.
2. In the clinical vignette site some examples and explained each phase.

Elisabeth Kübler-Ross established the five stages of grief model, which became well-
known with the publication of her book On Death and Dying in 1969. Kübler-Ross
created her model to depict persons confronting their own mortality due to terminal
illness. However, it was quickly adopted as a method of thinking about grief in general.

The five phases denial, anger, bargaining, depression, and acceptance – are frequently
spoken as though they occur sequentially, one after the other. In reality, Kübler-Ross
makes it plain in her literature that the phases are non-linear — people might experience
various characteristics of grief at different times, and they do not occur in a certain order.
You may not go through all of the phases, and your experiences may alter from one grief
to the next.
Denial is shock and When
disbelief regarding the loss. Margaret remained “level-
headed and composed”.
Numbness is normal in the
days following a remained
bereavement. Some people
first act as though as
nothing happened. Even
though we know in our
brains that someone has
died, it can be difficult to
accept that someone
significant will not return.
It's also normal to sense the
presence of a deceased
loved one, hear their voice,
or even see them.
Anger may be expressed
toward God, relatives,
friends, or health care
providers.
Anger is a fully natural
emotion, and it is especially
common after someone
dies. Death might seem
harsh and unfair, especially
if you believe someone died
before their time or if you
had future plans together.
It's also natural to feel
resentful of the person who
has died, or resentful of
ourselves for things we did
or didn't do before their
death.
Bargaining occurs when
the person asks God or fate
for more time to delay the
inevitable loss.
James died,
Crying spells lasted 6
months. She became “tired
of mourning” and would
ask herself, “When is this
going to be relieved?” She
also felt anger. “I was
upset with James,
wondering why he didn’t
go for his complete
physical. Maybe James’
death may not have
happened so soon.”
“If I had known what the
grief process was like, I
would never have married,
or I would have prayed
every day of my married
life that I would be the first
to die,”
When James died,
Margaret maintained her
stern demeanor as if
nothing had happened. She
sane and
composed. She was unable
to express the entire extent
of her sorrow, shock, and
disbelief that she is
experiencing as a result of
her loss. We might say that
the death of her husband
has not yet made its way
into her consciousness at
that moment.
Margaret was angry with
her husband at the time.
She believes that if her
husband had only taken
better care of himself, his
death may not have
happened so soon. It's
possible that becoming
angry with her husband is
one of her ways of
expressing her pain.
After a loss, bargaining is
frequently motivated by
feelings of guilt and
consists mostly of "if I/if
only" statements that are
centered on regrets about
what you did or did not do
When we are in agony, it before the person died.
might be difficult to realize People will go to any
that there is nothing we can length to avoid feeling the
do to improve the situation. pain of loss again. In
Bargaining is the process reference to Margaret's
through which we begin to situation, she stated that if
establish agreements with she only knew what it
ourselves, or possibly with would be like to be in
God if you are religious. grief, she would never
We want to think that if we consider getting married.
do certain things, we will She also stated that she
feel better. It's also typical should have prayed every
to find ourselves poring day for her to be the first to
over past events and asking die between her and her
a lot of 'what if' questions, husband.
wishing we could go back
in time and change things
in the hope that things
would have turned out
differently.
Depression results when One day shortly after the Each person experience
awareness of the loss funeral, she suddenly sadness at a particular
becomes acute. became aware of her point in his or her life.
exhaustion. While When someone loses a
When we think of sorrow, shopping, she found loved one, some people are
we usually think of sadness herself in protest of the hardly affected, while
and desire. This pain can emotional pain and others are distraught.
be excruciating and come wanting to shout, “Doesn’t Why? Because some
in waves that last for anybody know that I have people can preserve the
months or years. Life might just lost my husband?” idea that their loved one is
feel as though it no longer only gone on a vacation
has any significance, which and will return but some
can be terrifying. cannot.

Shortly after Margaret’s

Acceptance occurs when the
person shows evidence of
coming to terms with death.
husband's funeral, she began
to feel the effects of her
husband's death. Because of
the pain and exhaustion, she
was experiencing, she felt the
need to scream. She has
already realized that her
husband is no longer alive
and that he would never
return.
After a few months and well After a few months, Margaret
into the grief process, came to the realization that
Margaret knew she needed to she needed to do something

Grief comes in waves, and it
might feel as though nothing
will ever be the same again.
However, most individuals
gradually discover that the
agony subsides and that it is
able to accept what has
occurred. We may never 'get
over' the death of a loved one,
but we can learn to live anew
while keeping the memories of
people we've lost near to our
hearts.
“do something constructive.” productive with herself. She
She did. She attended support had already come to terms
groups, traveled, and became with her husband's death. She
involved with church became involved in support
activities. groups, traveled, and became
more involved in her church's
activities. Margaret's
acceptance does not mean
that she is fine with her
husband's death. It just means
that she has come to terms
with the new realities of her
existence. She is now a
widow, and she is now on her
own.

Reference:
https://www.cruse.org.uk/understanding-grief/effects-of-grief/five-stages-of-grief/
https://edition.cnn.com/2021/09/12/health/five-stages-of-grief-kubler-ross-meaning-
wellness/index.html