TERM 3- MY NOTES FOUNDATIONS OF NURSING CH.17 "COMPLEMENTARY AND ALTERNATIVE THERAPIES" Flashcards
Complementary therapies are therapies used in addition to conventional treatment recommended by a person’s health care provider. As the name implies, complementary therapies do not substitute for but rather complement the conventional treatment.
A)true
B)false
A
______________ therapies are therapies used in addition to conventional treatment recommended by a person’s health care provider. As the name implies, ___________ therapies do not substitute for but rather complement the conventional treatment.
Complementary
Complementary therapies include exercise, massage, reflexology, prayer, biofeedback, creative therapies (art, music, or dance therapy), guided imagery, acupuncture, relaxation strategies, chiropractic therapy, therapeutic touch, and herbalism
A)true
B)false
A
Alternative therapies, on the other hand, often include the same interventions as complementary therapies, but frequently become the primary treatment modality that replaces allopathic medicine (traditional or conventional Western medicine).
A)true
B)false
A
__________therapies, on the other hand, often include the same interventions as complementary therapies, but frequently become the primary treatment modality that replaces allopathic medicine (traditional or conventional Western medicine).
Alternative
The number of patients seeking unconventional treatments has risen considerably. Between one third and one half of the population of the United States uses one or more forms of CAM. In large part, this popularity is due to
(1) the perception that the treatments offered by the medical profession do not provide relief for a variety of common illnesses;
(2) the increasing interest of patients in becoming more eduucated about their health and the need to take a more active role in their treatment;
(3) the increased number of articles in journals such as Annals of Behavioral Medicine, Alternative Therapies in Health and Medicine, and Journal of Alternative and Complementary Medicine, as well as coverage of CAM therapies in respected general medical journals;
(4) programs seen on television; and
(5) the attraction to a holistic approach to health care that incorporates the mind, the body, and the spirit.
True
People also tend to turn to alternative therapies because they believe them to be less invasive and gentler than allopathic or traditional medicine and perceive them to incorporate a more holistic approach. Prevention is fundamental to most of the CAM therapies.
A)true
B)false
A
In contrast, the strength of allopathic medicine is its effectiveness in treating certain physical ailments (e.g., bacterial infections, structural abnormalities, acute emergencies). In general, it focuses less on preventing disease, decreasing stress-induced illnesses, managing chronic disease, and caring for the emotional and spiritual needs of individuals.
A)true
B)false
A
Many of the complementary therapies, such as acupuncture, make use of diagnostic and therapeutic methods specific to their field, whereas others, such as guided imagery, are essentially adjunctive in nature.
A)true
B)false
A
Project an open, nonjudgmental attitude when obtaining a health history so that the patient feels comfortable in providing all information about any therapies he or she is currently receiving
A)true
B)false
A
Insurance coverage is becoming more common for several of these treatments. Many policies cover chriopractic treatments and massage therapy if ordered by a health care provider. Acupuncture is also covered under some policies. Insurance companies are beginning to see the value of preventive measures, as well as treatment for acute injury or illness. From a risk management perspective, many of the alternative therapies are attractive since they work to maintain health, as well as restore it
A)true
B)false
A
The Office of Alternative Medicine (now the National Center for Complementary and Alternative Medicine) was established in 1992 as part of the National Institutes of Health. The goals of this office are to facilitate the evaluation of alternative medical treatment, specifically acting as a clearinghouse to distribute information to the public, the media, and professionals and supporting, coordinating, and conducting research and research training in the area of alternative medicine.
A)true
B)false
A
Holistic Nursing
,
Holistic nursing addresses and treats the mind-body-spirit of the patient.
A)true
B)false
A
Nurses use holistic nursing interventions such as relaxation therapy, guided imagery, music therapy, simple touch, massage, and prayer. Such interventions affect the whole person (mind-body-spirit) and are effective, economiy-scal, noninvasive, nonpharmacologic complements to medical care.Holistic interventions can be used to augment standard treatments, to replace interventions that are ineffective or debilitating, and to promote or maintain health.
A)true
B)false
A
The American Holistic Nursing Association (2007) maintains standards of holistic nursing practice, which define and establish the scope of holistic practice and describe the level of care expected from a holistic nurse.
- Nurses who provide holistic care need to recognize that prayer is a valued and frequently used coping strategy for many patients, especially cancer patients.
- One means at your disposal to help patients cope is to recognize and facilitate patients’ use of prayer.
- Patients are likely to pray at times of symptom distress and emotional distress, and during diagnostic and therapeutic processes. At such times, your help is valuable in fostering conditions and an environment conducive to prayer.
- Although there are commonalities in prayer experiences, typically prayer is unique to the individual. Therefore, you will be called on to design nursing strategies for facilitating prayer with sensitivity to the uniqueness of each patient.
- You contribute to the patient’s opportunity for prayer by helping the patient relax, offering spiritual reading material, placing the patient with a view of nature, offering a notebook for journaling, and safeguarding the patient’s privacy by preventing unnecessary intrusion into the room during this time.
True
HERBAL THERAPY
,
Herbalists were consulted by and worked in conjunction with medical physicians until the 1930s, when the last accredited herbal schools closed
A)true
B)false
A
Still, many of those drugs, as well as medications in use today, had their origins in herbs. An example is digitalis, which comes from the finger-shaped foxglove herb. Used in the treatment of heart failure, it is commonly prescribed by health care providers
A)true
B)false
A
The Dietary Supplement Health and Education Act passed in 1994 now allows for herbs to be sold as dietary supplements as long as there are no health claims written on their labels.
A)true
B)false
A
Because herb use is not widely accepted or understood by mainstream medical caregivers, patients often do not disclose their use of herbs to their health care provider. Many use prescription drugs concurrently with herbal remedies and face possible health risks as a result of adverse interactions
A)true
B)false
A
As a nurse, you help patients make educated decisions about their health; there is no reason for this to exclude the use of herbs
A)true
B)false
A
Teach patients that before taking any herbal product, it is best to review it with a health care professional, pharmacist, or certified herbalist.
A)true
B)false
A
Treatment is provided in a variety of ways. It is possible to take dried herbs orally in capsule or tablet form. Tinctures are made by placing herbs in alcohol or vinegar and allowed to sit until the Liquid absorbs the properties of the herb. The liquid is then strained and used.
A)true
B)false
A
Remind patients to take care to only use herbs from a reliable source. Before using any fresh herbs, it is best to obtain exact identification from a trained professional.
A)true
B)false
A
Always know exactly what the herb is and what its actions are before using any herb
A)true
B)false
A
Many herbs interact with various medications. For example,
-the combination of valerian and barbiturates will probably cause excessive sedation.
- Ginseng is likely to interfere with the actions of digoxin.
- Advise against taking St. John’s wort concurrently with antidepressant medications.
Screen patients carefully in regard to herbal use and possible interactions with other medications.
A)true
B)false
A
Commonly Used Herbs
,
-Asian ginseng (Panax ginseng)
Improves overall health and well-being
Atherosclerosis, bleeding disorders, colitis, diabetes, depressant cancer
Avoid use if taking anticoagulants because it can prolong clotting. Avoid taking with CNS stimulants, estrogen, furosemide, ibuprofen, caffeine. Drug interactions are possible with agents that inhibit monoamine oxidase (phenelzine, St. John’s wort, selegiline)
True
Aloe vera {Aloe ferox, A. barbadensis)
Burns, skin irritation Has laxative properties
Drug interactions exist with antidysrhythmics, cardiac glycosides (like digoxin), antidiabetics, beta blockers, steroids, diuretics, and disulfiram. Herb interactions exist with licorice
True
Echinacea (Echinacea purpurea, E. angustifolia, E. pal/ida)
Stimulates immune function; excellent blood cleanser; upper respiratory infections; wound healing
Drug interactions are possible with amprenavir, protease inhibitors, disufiram, metronidazole, immunosuppressants, cyclosporine and methotrexate, prednisone, alcohol, warfarin, digoxin, contraceptives, SSRis, MAOis.
True
Ginger (Zingiber officina/e)
Nausea, vomiting, motion sickness, appetite improvement, impotence, liver toxicity, burns
Drug interactions are possible with antacids, histamine H2 receptor blockers, proton pump inhibitors, anticoagulants, barbiturates, disulfiram, and metronidazole.
True
Ginkgo, Maidenhair tree (Ginkgo biloba)
Improves memory, increases circulation to the extremities and the brain
Adverse reactions include dizziness, headache, subarachnoid and subdural hemorrhage, and cardiac insufficiency. There have been reports of seizures in children and bleeding complications. Potential drug interactions exist with antiplatelet therapy, anticoagulants, anticonvulsants, buproprion, tricyclic antidepressants, disufiram, metronidazole, MAOis, SSRis, and trazodone. Herb interactions include garlic.
True
Lavender (Lavandula officina/is)
Antiseptic, antidepressant, sedative Relaxation, minor cuts, psoriasis, fragrance
Used for its calming mild sedative effect. Add to warm bath water if desired to aid in relaxation
Excessive inhalation of the oil sometimes leads to vertigo, nausea, and syncope. Tell patients to avoid hazardous activities until full effects are known.
True
St. John’s wort (Hypericum perforatum)
Mild to moderate depression, anxiety, viral infection, insomnia, premenstrual syndrome, topical myalgia, inflammation
Drug interactions include amiodarone, amitriptyline, chemotherapy drugs, cyclosporine, digoxin, drugs metabolized in cytochrome P-450 system, contraceptives (oral). protease inhibitors, theophylline and warfarin, SSRis, reserpine, and nonnucleoside reverse transcriptase inhibitors.
True
Tea tree oil (Melaleuca alternifolia)
Skin irritations, acne, athlete’s foot Topical antiseptic, antifungal inhalation for respiratory disorders
Do not take in combination with drugs that affect histamine release. Do not apply to dry skin, cracked or broken skin, open wounds, or areas affected by rash that is not fungal. Do not use internally because of systemic toxicity.
Do not use around nose, eyes, and mouth because it sometimes causes burns or pruritus in tender areas. Use the pure oil only with close supervision by a health care provider.
True
Other herbs
,
Cayenne (Capsicum sp.)
General cardiovascular health. reduces cholesterol level; topical application produces analgesia, controls bleeding
Drug interactions exist with ACE inhibitors, heparin, ASA, disulfiram, and theophylline. Herb interactions exist with feverfew, garlic, ginger, and ginseng.
True
Comfrey (Symphytum officina/e)
Cell proliferent, stimulates quick healing of strains and slow-healing wounds (for external use only)
Umit use to 4 to 6 weeks per year to prevent exposure to large amounts of toxic alkaloids.
True
Valerian (Valeriana officina/is)
Insomnia, hyperactivity, stress, anxiety
Causes addictive effects in some patients taking barbiturates
Possible adverse reactions include hepatotoxic withdrawal.
True
Patient Teaching Using Complementary and Alternative Therapies
,
- Use herbal preparations according to package or health care provider direction.
- When taking ginkgo, keep seeds out of children’s reach because of the potential risk of seizures with ingestion.
- Consult your health care provider before starting a yoga program because some yoga postures are stressful to people with certain health problems (muscle injury is possible if the positions are not done correctly or if the body is forced into certain positions).
- Yoga is a complementary therapy, not a cure for disease. Patient will need to continue any conventional medical treatments he or she is currently following.
- When practicing yoga, try different positions cautiously; few people are able to do all the movements in the beginning. Yoga requires regular practice to be effective.
- Inform your primary care provider of any drugs you use, including herbal remedies, so that all agents-whether “nutraceutical” or pharmaceutical-will be considered in the plan of care.
- Stop taking the herb and notify your primary care provider if adverse effects or side effects occur.
- Avoid using combinations of herbs.
- “Natural” does not mean safe.
- Seek objective and scientifically based sources of information. Use caution when evaluating the claims made by herb manufacturers.
- Use only products that are standardized and known to contain a specific amount of active ingredients.
- Select herbal products carefully, buying only those that list the following information on the package: herb’s common and scientific names, name and address of the manufacturer, batch or lot number, expiration date, dosage and administration guidelines, potential side effects, and details of how quality is ensured.
- Avoid using herbs and spices for at least 2 weeks before any surgery.
- Bear in mind that patients who self-prescribe medications will possibly have serious underlying physiologic or psychological conditions that require attention. Teach patient to devise health regimen that best suits his or her needs-whether or not herbs are used.
True
- Herb-drug interactions do occur, as well as herb-herb interactions, and they pose serious risks; therefore, it is best to let the primary care provider determine the safety of combining herbs and drugs.
- Purchase herbal products that have been standardized, that is, products for which the effects are known for a given dosage and for which the manufacturer ensures consistency from batch to batch.
- Buy from reputable sources. Ask the primary health care provider for assistance in determining where to purchase herbs.
- Avoid herbs during pregnancy and lactation or when attempting to become pregnant.
- Neither the safety nor the efficacy of herbs has been conclusively documented in scientific literature.
- It is in the patient’s best interest to undergo a complete medical evaluation before self-medicating with supplements whether to treat specific symptoms of an illness or as a preventive measure.
- Do not use herbs in larger-than-recommended dosages or for more than several weeks (unless approved by the health care provider).
- Do not give infants, children, and older adults herbal treatments without professional supervision.
- Postpone reflexology treatment if patient’s feet have cuts, boils, bruises, or other injuries.
- Check with your health care provider before trying reflexology if patient has diabetes, peripheral vascular disease, or other vascular problems in the legs, such as thrombosis or phlebitis.
- Many people who claim to perform reflexology actually are performing a simple foot massage; advise patient to make sure the therapist has been trained in reflexology.
- Keep all herbs out of the reach of children and pets.
True
Common Essential Oils and Their Uses
,
Eucalyptus
Use:
Respiratory problems
True
Lavender
Use:
Insomnia, stress, depression
Possibly causes CNS depression, confusion, vertigo, syncope, drowsiness, headache, neurotoxicity, hypotension, nausea, vomiting, constipation, and respiratory depression
True
Lemon
Use:
Colds and flu, mental stimulation Diuretic, antiinflammatory
True
Peppermint
Use:
Acne, stomach upset General stimulant
Patients with gastroesophageal reflux disease should avoid because peppermint sometimes exacerbates it
True
Rosemary
Use:
Internally: Mental stimulant; use for stress, circulatory problems
Externally: myalgias, neuralgia, pruritus, migraines
Promotes menstrual flow, induces abortions (do not use if pregnant); and relieves headache, liver, and gallbladder complaints and blood pressure problems. In high doses sometimes causes seizures.
True
Tea tree
Use:
Antiseptic Skin irritations, viral illness, respiratory infection
Topical applications have not shown to be toxic, but ingesting the oil will possibly produce CNS depression and gastrointestinal irritation
True
CHIROPRACTIC THERAPY
,
Chiropractic therapy has been in existence since the late 1800s. Doctors of chiropractic medicine undergo extensive training in manipulation of the musculoskeletal system.
A)true
B)false
A
A doctor of chiropractic medicine does not prescribe medications as part of the treatment.
A)true
B)false
A
Other treatments, such as hot and cold packs, are sometimes used during the course of chiropractic treatment. The chiropractor will often consider lifestyle changes to help keep the patient functioning well without recurrence of the injury
A)true
B)false
A
LIMITATIONS OF CHIROPRACTIC THERAPY
,
It is unwise to treat certain diseases or joint conditions with manipulation.
A)true
B)false
A
Contraindications for chiropractic therapy include acute myelopathy, fractmes, dislocations, rheumatoid arthritis, and osteoporosis. If a malignancy is suspected or determined through diagnostic testing, see that the patient is referred to a health care provider for further evaluation and treatment.
A)true
B)false
A
ACUPUNCTURE AND ACUPRESSURE
,
Acupuncture and acupressure are therapies that are based on the belief that there is a form of energy or Qi (life force) that flows through the body along meridians (channels of energy)
A)true
B)false
A
These meridians, or channels, can become blocked, thus causing illness or discomfort. Therapy involves stimulating the channels at specific points to open them and allow the Qi to flow freely.
A)true
B)false
A
Pain is understood to result primarily from stagnant or blocked Qi, and opening up the dam in the flow of energy through a meridian relieves the pain.
A)true
B)false
A
Acupuncture is a method of stimulating certain points (acupoints) on the body by the insertion of special needles to modify the perception of pain, normalize physiologic functions, or treat or prevent disease. Fine needles inserted at specific points serve to open the meridians. These needles are sterile and extremely thin, much smaller than the needles used for insulin injection; each one is for one-time use only.
A)true
B)false
A
When all the needles are in place, the needles are stimulated manually, electrically, or with heat.
A) Acupuncture
B) Acupressure
A
After the needles have been in place for about 20 minutes, the practitioner removes and discards them. There is usually little discomfort while the needles are inserted, and most patients state that they feel no distress at all.
A) Acupuncture
B) Acupressure
A
Acupuncture is the primary treatment modality used by physicians of Chinese medicine. Many allopathic or conventional Western physicians and health care professionals are also being trained and certified in acupuncture
A)true
B)false
A
The most common problems for which acupuncture is used include low back pain, myofascial pain, simple and migraine headaches, sciatica, shoulder pain, tennis elbow, osteoarthritis, whiplash, and musculoskeletal sprains
A)true
B)false
A
Other problems that have been successfully treated include sinusitis, gastrointestinal disorders, bladder leakage, premenstrual symptoms, neurologic disorders, chronic pulmonary disease (including asthma), hypertension, smoking and other addictions, and clinical depression
A) Acupuncture
B) Acupressure
A
Acupressure uses gentle pressure at similar points on the body. Pressure is sometimes applied with a finger and sometimes with a small, blunt object.
A)true
B)false
A
Acupressure is used primarily for prevention and relief of symptoms of muscle tension. The healing touch of acupressure reduces tension, increases circulation, and enables the body to relax deeply.
A)true
B)false
A
By relieving stress, acupressure increases resistance to disease and promotes wellness.
A)true
B)false
A
Acupressure is beneficial in situations of discomfort and promotes the ability to rest or sleep
A)true
B)false
A
THERAPEUTIC MASSAGE
,
Therapeutic massage is massage performed by trained professionals to manipulate the soft tissues of the body and assist with healing
A)true
B)false
A
A patient with phlebitis or thrombosis needs to avoid massage of the affected extremity. Infectious skin diseases are also conditions where massage is contraindicated.
A)true
B)false
A
A session will last approximately an hour. A whole-body massage is sometimes done, with extra attention being given to the affected area. Oils or lotions are often used during the massage. Make sure the patient is checked for allergies before their use.
A)true
B)false
A
Life Span Considerations
Older Adults
Focus on Touch
,
- Touch is a primal need, as necessary as food, growth, or shelter. Think of touch as a nutrient transmitted through the skin. “Skin hunger” has been described as a form of malnutrition that has reached epidemic proportions in the United States, especially among older adults.
- Older adults need touch as much as or more than any other age-group. However, skin hunger or poverty of touch is often acute among older adults. It is an unfortunate irony that older adults often have fewer family members or friends to touch them just at the time when there is greatest need to use simple touch to enhance communication or when other senses are sometimes reduced in acuity.
- Simple touch helps older adult patients feel more connected to and accepted by those around them and to their environment. Self-esteem and sense of worth are enhanced.
- A nurse who reacts adversely to the skin changes of older adults will perhaps find it difficult to touch an older patient. Such reluctance goes on to communicate a negative message to the older adult.
- A truly holistic nursing approach to the care of older adults also includes the caregivers, who often experience poor health or have neglected their own health, find themselves challenged by their own psychosocial issues as they relate to the caregiving experience, feel the effects of multiple stressors, or feel spiritual distress.
True
AROMA THERAPY
,
Aromatherapy uses pure essential oils, produced from plants, to provide health benefits. The oils are formulated for inhalation or are applied topically. Sometimes the scent is dispersed into the air through the use of candles or oil dispersers.
A)true
B)false
A
Aromatic oils are often used during massage. Bathing provides a good modality for aromatherapy when oil is added to the water. Occasionally, essential oils will be taken orally in small amounts but only when prescribed by a qualified practitioner.
A)true
B)false
A
Many scents are put to use for their psychological effects. Different scents are thought to invoke different responses in the body as well
A)true
B)false
A
Aromatherapy works on similar principles. Specific scents are thought to relax or stimulate, improve digestion, increase hormone production, and improve circulation or memory.
A)true
B)false
A
Asthmatic patients will sometimes develop exagggerated symptoms from certain aromatic essence. Do not use essential oils on the skin of a patient with atopic eczema.
A)true
B)false
A
REFLEXOLOGY
,
In reflexology it is thought that it is possible to exert an effect on the entire body by applying pressure to specific areas on the feet.
A)true
B)false
A
Reflexology is based on the premise that there are zones and reflexes in different parts of the foot that correspond one-to-one to each -part, gland, and organ of the body. The manipulation of specific reflexes removes stress, enabling the release of disharmonies by a physiologic change in the body.
A)true
B)false
A
Reflexology demonstrates the following four main benefits:
- Relaxes the body and removes stress
- Enhances the circulation
- Assists the body to normalize metabolism naturally
- Complements all other healing modalities
True
When the reflexes are stimulated, the body’s natural electric energy works along the nervous system pathways and meridian lines to clear any blockages along those lines and in the corresponding zones
A) Reflexology
B)false
A
Treatments typically last up to 1 hour. Most people find treatments to be very relaxing.
A)true
B)false
A
WARNINGS, CONTRAINDICATIONS, AND PRECAUTIONS
,
Use lighter pressure on the corresponding reflex areas when heart problems, blood problems, high blood pressure, epilepsy, or diabetes are present
A) Reflexology
B)false
A
In diabetic patients using artificial insulin,overstimulation of the corresponding reflexes will possibly cause the pancreas to start producing insulin again and thus lead to a higher level of insulin than expected.
A)true
B)false
A
MAGNET THERAPY
,
Natural lodestones were found and are the earliest form of magnets known. Currently, a variety of companies produce magnets for use on various parts of the body. Magnets are sometimes used intermittently and sometimes worn all the time.
A)true
B)false
A
Magnets are used to increase circulation, increase energy, and decrease pain.
A)true
B)false
A
Although it is not known . exactly how magnets work, they are thought to increase circulation to the affected area and promote healing, as well as stimulate acupuncture points
A)true
B)false
A
Common physiologic responses resulting from magnetic field exposures include the following actions:
(1) vasodilation;
(2) analgesic action;
(3) antiinflammatory action;
(4) spasmolytic (arresting spasms) activity;
(5) acceleration of healing; and
(6) antiedema activity.
The magnet is placed over the affected area and held in place by jewelry, cloth wraps, or tape. Magnet insoles are available to place in shoes.
A)true
B)false
A
Contraindications of magnets include pregnancy and the presence of pacemakers, insulin delivery systems, cochlear implants, and defibrillators, and concurrent use of an electric blanket or heating pad.
A)true
B)false
A
Magnets are also not to be used with patients with myasthenia gravis because muscle weakness will possibly be aggravated because of the magnet’s strong action on relaxing muscles.
A)true
B)false
A
Other conditions in which magnets are contraindicated include hyperthyroidism and adrenal gland, hyypothalamic, and pituitary dysfunction.
A)true
B)false
A
