chapter 28-prep u

A client asks the nurse for information about Traditional Chinese Medicine. The client specifically asks how Traditional Chinese Medicine might help manage one's chronic migraines. Which response by the nurse is best?

"Acupuncture uses fine needles inserted in the skin to stimulate natural painkillers and has proven to be beneficial in treating chronic migraines."

When obtaining information for a database, which of the following represents a nurse commitment and interest in reflected integrative medicine (CAM)?

"Do you take any vitamins or minerals, and if so, what?"

A nurse is teaching a client about healthy food choices using a holistic approach. The nurse determines that additional teaching is needed based on which client statement?

"I can have a can of soda as often as I want to."

A client with dermatitis has sought care from a homeopathic practitioner seeking treatment for dry, itchy, and inflamed skin. Which statement is characteristic of homeopathy?

"I'm going to recommend a diluted solution that is derived from poison ivy."

The nurse in a medical unit is collecting a client's history and asks the client about the use of complementary and alternative therapies. The client asks why the nurse needs to know about this. What is the nurse's best response?

"It's important that we list all of your complementary health practices used to provide a full picture of what you do to manage your health.

A client asks the nurse about taking herbal medications. Which of these is the nurse's best response regarding safety of the herbal medications?

"Name brand products with herbal medications usually are of higher quality."

A client with stage IV colon cancer reports back pain and appears to be anxious. What response should the nurse provide when asked if therapeutic touch may be beneficial?

"Therapeutic touch is a holistic practice that works to redirect energy in the body and may help with pain and anxiety."

Which question or statement to a client conveys acceptance?

"Will you please share with me the prescription medicines and vitamins you take?"

A nurse practitioner is conducting a class for a local community group about complementary health approaches. One of the participants asks the nurse, "How are these approaches different from traditional medicine?" Which response by the nurse would be appropriate? Select all that apply.

-"Illness is influenced by the interaction of your mind, body, and spirit, not just one or the other." -"Illness is viewed as a manifestation of some imbalance or disharmony."

A nurse is teaching a client with anxiety about the use of meditation. Which of these are important features of meditation? Select all that apply.

-A quiet location -An open attitude -A comfortable position

The nurse is educating a client on how to use herbs and supplements as part of an integrated treatment plan. Which teaching points would the nurse include? Select all that apply.

-Buy herbs and supplements that are standardized. -Give the product adequate time to work. -Be knowledgeable about the product and its therapeutic actions.

In prenatal classes, the nurse teaches pregnant clients to use meditation during labor contractions to ease the pain. Which elements of meditation are important for the nurse to emphasize? Select all that apply.

-Comfortable position -Quiet environment -Focus of attention

A nurse is teaching a class on holistic nutritional therapy to a group of young and middle-aged adults in the community. The nurse creates a menu of food and beverage choices and asks the group the select the best choices. The nurse determines that the teaching was successful when the group chooses which food? Select all that apply.

-Fresh corn on the cob in season -Organically grown chicken -Bottled spring water

A nurse is teaching a group of middle-aged adults about the different types of mind-body practices that can be used to help promote health. One of the participants asks the nurse, "How would yoga help me?" After describing the various physical postures used with yoga, the nurse would include which as an effect? Select all that apply.

-Improved flexibility -Increases endurance -Greater relaxation -Reduces stress

The nurse is teaching a class on methods of relaxation to be used for stress management. Which methods should the nurse teach the participants? Select all that apply.

-Meditation -Biofeedback -Imagery -Focused breathing

The nursing instructor is discussing complementary and alternative medicine with a group of students. One of the students questions "What therapies are considered complementary and alternative medicine?" The instructor bases her response on her knowledge that which of the following are considered complementary and alternative therapies? Select all that apply.

-Relaxation -Qi gong -Acupuncture -Prayer

A nurse who has incorporated complementary and alternative medicine (CAM) into nursing practice is caring for a client in a short-term care facility. Which examples of nursing interventions are based on CAM? Select all that apply.

-The nurse investigates herbs that may stimulate the client's immune system. -The nurse encourages the client to join a yoga class. -The nurse teaches the client how to meditate. -The nurse uses guided imagery to relieve client anxiety.

A client is following a Mediterranean diet to increase heart health. The nurse would offer which items as a snack? Select all that apply.

-Whole grain crackers -Fruit -Carrots with humus

Which nursing action exemplifies the use of integrative care?

A nurse instructs a laboring woman to use breathing exercises, and assists with the administration of an epidural for her pain.

While assessing a client, the client tells the nurse that he is a follower of traditional Chinese medicine and the concept of qi. Based on the nurse's understanding of this concept, which treatment modality would the nurse expect the client to mention?

Acupuncture

A client is asking for the nurse to explain acupuncture. What would the nurse tell the client?

Acupuncture is used to correct disharmony.

A nurse is reading an online journal article about different approaches to health. The nurse is reading about a practice approach that is supported by evidence-based practice and is particularly effective when aggressive treatment is needed in an emergency situation. The nurse is reading about which type of approach?

Allopathic

The nurse explains to the client which statement is true regarding the difference between allopathic therapy and complementary and alternative therapy?

Allopathic therapy emphasizes treatments for diseases. Complementary and alternative therapy emphasizes treatments for health.

A nurse is caring for a client admitted for a prolonged stay on a medical-surgical unit. The client has been having difficulty sleeping and appears depressed. Applying the holistic health model, which action taken by the nurse would be most appropriate?

Ask the client's family to bring some items from home, such as a blanket, pillow, or pictures

A nurse can best help a client who is undergoing chemotherapy and using guided imagery with this by doing which of the following?

Assisting the client to find an appropriate imagery tape to use.

Which would be the least consistent with the Native American/Canadian Indigenous view of disease?

Balance of yin and yang

A client comes into the clinic stating he has been experiencing insomnia for a couple of weeks. After a thorough exam revealed no physiological cause for the symptom, the nurse practitioner suggested the use of aromatherapy. Which of the following might the nurse suggest for its use in helping insomnia?

Chamomile

A client is in the last stage of labor. During each contraction, she is focusing on her husband's voice and a picture brought from home. She is demonstrating which type of meditation?

Concentrative

A nurse is caring for a hospitalized client who states: "I feel so sick all the time; my aura must be disturbed by all of these bad force fields." What is an appropriate NANDA-I diagnosis for this client?

Disturbed energy field

Which is the most important role of the nurse in using complementary and alternative therapies?

Educating the public about safety and effectiveness

The client who is newly diagnosed with diabetes mellitus type 2 is concerned about eating products with sugar in them. What information does the nurse explain to the client regarding the use of sugar?

Excess sugar increases demand on the pancreas.

A client who is receiving chemotherapy and experiencing significant nausea asks the nurse about using aromatherapy to help alleviate the nausea. Which essential oil would the nurse most likely suggest to address the client's nausea?

Ginger

A client asks the nurse about the use of healing touch. Which statement regarding healing touch is accurate?

Healing touch does not use injections.

The nurse is caring for a client whose treatment has been based on the Ayurveda medical system. Which nursing intervention incorporates this client's beliefs into the nursing plan?

Helping the client to balance his or her dosha

A nurse is teaching a client experiencing stress about how relaxation helps to reduce the effects of stress on the body. Which underlying concept would the nurse integrate into the explanation about how relaxation works?

Helps to increase the effects of parasympathetic nervous system on the mind and body

A home care nurse delivers care that incorporates a philosophy that focuses on connections and interactions between parts of the whole. Which term best describes this philosophy?

Holism

The nursing instructor is discussing alternative therapy with a group of students. She explains that living organisms are "continuously connecting and interacting with their environment." Furthermore, the connecting and interacting signifies that the human body is a unified dynamic whole. The instructor is describing what theory to the students?

Holism perspective

A client refuses to take a prescribed medication dose and requests the nurse administer the lowest dose of medication possible. The nurse understands that this is related to the client's belief in which complementary-alternative medicine system?

Homeopathy

After developing good rapport with a client over the past several weeks, a nurse has offered to perform Therapeutic Touch (TT) on a client who has been experiencing recurrent nausea. Which principle underlies TT?

Illness results from an imbalanced energy field.

Which of the following has been known to achieve benefits for clients with cancer through the use of the mind to visualize a positive physiologic effect?

Imagery

Ayurvedic medicine has its roots in which of the following areas?

India

The nurse is caring for a 48-year-old Native American/First Nations client hospitalized following a myocardial infarction. The client tells the nurse about not understanding the plan of care and asks to see the healer from home. The nurse arranges for the healer to come see the client. What primary benefit will the healer provide for the client?

Integrative health care that is part of the client's particular belief system can be developed by the healer that incorporates both traditional and complementary medicine.

The spouse of a client diagnosed with early memory loss asks about the use of ginkgo biloba as a dietary supplement. Which nursing assessment is essential prior to responding?

Is the client taking warfarin or aspirin?

A nurse is applying healing touch to a postoperative client's wound. What benefit of healing touch should the nurse emphasize to the client's family?

It will help the wound heal.

Which of the following manipulative therapies involves applying pressure and movement to stretch soft tissues?

Massage therapy

The client has been diagnosed with a disease and is seeking information about naturopathy. The nurse, explaining about naturopathy, encourages the client to do what?

Obtain adequate sleep each night.

An occupational therapist conducts daily relaxation exercises with clients who are receiving treatment on the psychiatric unit of a hospital. Stimulation of which of the following components of the nervous system will result in relaxation for the clients?

Parasympathetic nervous system

The client with lymphoma is admitted to the oncology unit for chemotherapy treatment. Which action would the nurse take in performing therapeutic touch?

Place the hands 1 to 2 in (2.5 to 5 cm) over the client's body moving them in a head-to-toe fashion.

A client at the clinic is considering the use of acupuncture to assist with smoking cessation. When describing this practice, the nurse would explain that which concept is involved as the focus?

Qi

The nurse is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first?

Requesting the client's permission to touch the body

Which scenario is an example of tertiary prevention?

Sam is prescribed an antihypertensive medication to control his newly diagnosed high blood pressure.

A nurse who "unblocks" and "clears" congested areas of energy in a client's body to promote comfort is applying the phenomenon known as:

Therapeutic Touch (TT)

The nurse is writing a script to use in guided imagery. To be most effective, this script should include which component?

Use of all five senses

According to survey results, who are the most prevalent users of complementary or alternative therapies?

Women, ages 35-50, with college degree, former smokers

A client is experiencing lower back and joint pain secondary to a fall and comes to the clinic for a visit. When discussing possible mind-body practices that might be helpful for pain relief, which approach would the nurse suggest? Select all that apply.

Yoga Tai chi Meditation

A nurse mentor is teaching a new nurse about the underlying beliefs of CHAs versus allopathic therapies. Which statements by the new nurse indicate that teaching was effective? Select all that apply.

a-"CHA proponents believe the mind, body, and spirit are integrated and together influence health and illness." b-"CHA proponents believe that health is a balance of body systems: mental, social, and spiritual, as well as physical." e-"The emphasis is on disease for allopathic proponents and drugs, surgery, and radiation are key tools for curing." With CHA, mind, body, and spirit are integrated and together influence health and illness, and illness is a manifestation of imbalance or disharmony. Allopathic beliefs include: The main causes of illness are considered to be pathogens (bacteria or viruses) or biochemical imbalances, curing seeks to destroy the invading organism or repair the affected part, and emphasis is on disease and high technology. Drugs, surgery, and radiation are among the key tools for dealing with medical problems. According to allopathic beliefs, health is the absence of disease.

A nurse cares for patients in a chiropractic office. What patient education might this nurse perform? Select all that apply.

a-Applying heat or ice to an extremity b-Explaining the use of electrical stimulation c-Teaching a patient relaxation techniques f-Teaching about dietary supplements Chiropractors may combine the use of spinal adjustments and other manual therapies with several other treatments and approaches including heat and ice, electrical stimulation, relaxation techniques, rehabilitative and general exercise, counseling about weight and diet, and using dietary supplements. Chiropractors do not prescribe medication or perform invasive procedures.

A nurse manager who works in a hospital setting is researching the use of energy healing to use as an integrative care practice. Which patient would be the best candidate for this type of CHA?

a. A patient who is anxious about residual pain from cervical spinal surgery Energy healing is focused on pain that lingers after an injury heals, as well as pain complicated by trauma, anxiety, or depression. Nutritional and herbal remedies treat all chronic pain, but especially abdominal discomfort, headaches, and inflammatory conditions, such as rheumatoid arthritis.

A nurse is caring for a patient who has crippling rheumatoid arthritis. Which nursing intervention best represents the use of integrative care?

a. The nurse administers naproxen and uses guided imagery to take the patient's mind off the pain. Adding guided imagery (CHA) to the administration of pain medications (allopathy) is an example of integrative care. A person who uses integrative care uses some combination of allopathic medicine and CHA.

What term is defined as "those practices that do not form part of the dominant system for managing health and disease"?

alternative medicine

A nurse works for a health care provider who practices the naturopathic system of medicine. What is the focus of nursing actions based on this type of medical practice? Select all that apply.

b- Providing patient education d-Making appropriate interventions to prevent illness e-Believing in the healing power of nature f-Encouraging patients to take responsibility for their own health Naturopathic medicine is not only a system of medicine, but also a way of life, with emphasis on patient responsibility, patient education, health maintenance, and disease prevention. Its principles include minimizing harmful side effects and avoiding suppression of symptoms, educating patients and encouraging them to take responsibility for their own health, treating the whole person, preventing illness, believing in the healing power of nature, and treating the cause of a disease or condition rather than its symptoms.

At a follow-up visit, a patient recovering from a myocardial infarction tells the nurse: "I feel like my life is out of control ever since I had the heart attack. I would like to sign up for yoga, but I don't think I'm strong enough to hold poses for long." What would be the nurse's best response?

b. "There is a slower-paced yoga called Kripalu that focuses on coming into balance and relaxation that you could look into." Kripalu, or "gentle yoga," focuses on relaxation and coming into balance. Ashtanga focuses on synchronizing breath with a fast-paced series of postures. The nurse should not discourage the use of yoga in patients who are healthy enough to participate. Yoga is not contraindicated in patients with controlled high blood pressure.

A nurse working in a long-term care facility incorporates aromatherapy into her practice. For which patient would this nurse use the herb ginger?

b. A patient who has nausea Commonly used essential oils in a health care setting are ginger or peppermint for nausea and lavender or chamomile for insomnia.

A nurse is providing a lecture on CHAs to a group of patients in a rehabilitation facility. Which teaching point should the nurse include?

c. Many nurses are expanding their clinical practice by incorporating CHA to meet the demands of patients. Many nurses are expanding their clinical practice by incorporating CHA. Although CHA may seem totally safe, some therapies have led to harmful and, at times, lethal outcomes. Many patients use these types of therapies as outpatients and want to continue their use as inpatients. Although the use of most complementary and alternative therapies predates modern medicine, it was not until recently that nursing and medical schools began to teach about their use.

A nurse is guiding a patient in the practice of meditation. Which teaching point is most useful in helping the patient to achieve a state of calmness, physical relaxation, and psychological balance?

c. Teach the patient to let distractions come and go naturally without judging them. Meditators should have an open attitude by letting distractions come and go naturally without judging them. They should also maintain a specific, comfortable posture lying down, sitting, standing, walking, etc.; focus attention on a mantra, object, or breathing; and not suppress distracting or wandering thoughts; instead they should gently bring attention back to focus.

During a client interview, the client tells the nurse about using ginkgo biloba to improve memory. When reviewing the client's medication history, which medication would be a cause for concern?

clopidogrel

A nurse is caring for a postoperative patient who is experiencing pain. Which CHA might the nurse use to ensure active participation by the patient to achieve effective pre- or postoperative pain control?

d. Guided imagery Imagery involves using all five senses to imagine an event or body process unfolding according to a plan. A patient can be encouraged to "go to a favorite place." With the other modalities, the patient is more passive.

A nurse is educating a client on meditation techniques to provide mental calmness and physical relaxation. Which nursing intervention facilitates this process?

helping the client to assume a specific, comfortable posture

The mind and body are connected in the provision of care. This statement describes:

holistic care.

Which of the following forms of medicine combines health promotion, establishment of a partnership with the client and practitioner, and captures an evolving model of health care?

integrative health care and medicine

A client comes to the clinic for an evaluation. The client reports that "I have been having such problems with getting to sleep and then staying asleep. But I do not want to take any medications." After a discussion of possible complementary health approaches, the client decides to try aromatherapy. Which essential oil will the nurse suggest to address the client's problem?

lavender

A nurse is interviewing a client who has come to the clinic for an evaluation. During the visit, the client tells the nurse that she also sees a provider who practices traditional Chinese medicine. The client describes treatment using acupuncture with the burning of an herb above the acupuncture needle. The nurse interprets this as:

moxibustion.

On the advice of friends, a client on a palliative care unit has requested acupuncture. What it is the goal of this form of CAM?

restoring a healthy flow of energy along the meridians of the body