Chapter 33 Complementary and Alternative Therapies

the importance of touch

-a primal need, as necessary as food, growth or shelter -older adults need touch as much as or more than any other age group -simple touch helps older adults feel more connected to and accepted by those around them and more in tune with their environment; enhances self-esteem and sense of worth -keep in mind adverse skin changes and reluctance communicates a negative message; be aware of your own reactions

safety and effectiveness

-carefully select CAM practitioners with appropriate training and experience -take time to research and understand the treatment -treatment may not be covered by insurance -be aware of scams -beware of possible side effects -possible interaction of supplements with current medications

Which of the following statements best explains the actions of therapeutic touch (TT)? 1. Intentionally mobilizes energy to balance, harmonize, and repattern the recipient's biofield 2. Intentionally heals specific diseases or corrects certain symptoms 3. Is overwhelmingly effective in many conditions 4. Is completely safe and does not warrant any special precautions

1. Intentionally mobilizes energy to balance, harmonize, and repattern the recipient's biofield

The nurse manager of a community clinic arranges for staff in-services about various complementary therapies available in the community. What is the purpose of this training? Select all that apply. 1. Nurses have a long history of providing some of these therapies and need to be knowledgeable about their positive outcomes. 2. Nurses are often asked for recommendations and strategies that promote well-being and quality of life. 3. Nurses play an essential role in patient education to provide information about the safe use of these healing strategies. 4. Nurses appreciate the cultural aspects of care and recognize that many of these complementary strategies are part of a patient's life. 5. Nurses play an essential role in the safe use of complementary therapies. 6. Nurses learn how to provide all of the complementary modalities during their basic

1. Nurses have a long history of providing some of these therapies and need to be knowledgeable about their positive outcomes. 2. Nurses are often asked for recommendations and strategies that promote well-being and quality of life. 3. Nurses play an essential role in patient education to provide information about the safe use of these healing strategies. 4. Nurses appreciate the cultural aspects of care and recognize that many of these complementary strategies are part of a patient's life. 5. Nurses play an essential role in the safe use of complementary therapies.

What role do patients have in complementary and alternative therapies? 1. Submissive to the practitioner 2. Actively involved in the treatment 3. Allow practitioner to experiment 4. Total believer in what is being taught

2. Actively involved in the treatment

A nurse is caring for a patient experiencing a stress response. The nurse plans care with the knowledge that systems respond to stress in what manner? Select all that apply. 1. Always fail and cause illness and disease 2. Cause negative responses over time 3. React the same way for all individuals 4. Protect an individual from harm in the short term

2. Cause negative responses over time 4. Protect an individual from harm in the short term

In addition to an adequate patient assessment, when a nurse uses one of the nursing-accessible complementary therapies, he or she must ensure that which of the following has occurred? 1. The family has provided permission. 2. The patient has provided permission and consent. 3. The health care provider has given approval or provided orders for the therapy. 4. He or she has documented that the patient has a complete understanding of complementary and alternative medicine.

2. The patient has provided permission and consent.

Traditional Chinese medicine (TCM) is used by many patients. Which statement most accurately describes intervention(s) offered by TCM providers? 1. Uses acupuncture as its primary intervention modality 2. Uses many modalities based on the individual's needs 3. Uses primarily herbal remedies and exercise 4. Is the equivalent of medical acupuncture

2. Uses many modalities based on the individual's needs

Several nurses on a busy unit are using relaxation strategies while at work. What is the desired workplace outcome from this intervention? Select all that apply. 1. Improved health among the staff 2. Increased patient safety 3. Improved staff satisfaction 4. Improved staff relationships 5. Fewer overtime assignments

3. Improved staff satisfaction 4. Improved staff relationships

While planning care for a patient, a nurse understands that providing integrative care includes treating which of the following? 1. Disease, spirit, and family interactions 2. Desires and emotions of the patient 3. Mind-body-spirit of patients and their families 4. Muscles, nerves, and spine disorders

3. Mind-body-spirit of patients and their families

A nurse is planning care for a group of patients who have requested the use of complementary health modalities. Which patient is not a good candidate for guided imagery? 1. Pregnant patient 2. Hypertensive patient 3. Patient with posttraumatic stress disorder (PTSD) 4. A pediatric patient

3. Patient with posttraumatic stress disorder (PTSD)

Which complementary therapies are most easily learned and applied by a nurse? Select all that apply. 1. Massage therapy 2. Traditional Chinese medicine 3. Progressive relaxation 4. Breathwork and guided imagery 5. Therapeutic touch

3. Progressive relaxation 4. Breathwork and guided imagery

Which statement best describes the evidence associated with complementary therapies as a whole? 1. Many clinical trials in complementary therapies support their effectiveness in a wide range of clinical problems. 2. It is difficult to find funding for studies about complementary therapies. Therefore we should not expect to find evidence supporting its use. 3. The science supporting the effectiveness of complementary therapies is early in its development. 4. Most of the research examining complementary and alternative therapies has found little evidence, suggesting that, although people like them, they are not effective.

3. The science supporting the effectiveness of complementary therapies is early in its development.

A nursing professor is teaching a nursing student about caring patients who use herbal preparations in addition to prescribed medications. Which of the following statements made by the student indicates that the student understands herbal preparations? 1. "Herbal preparations are regulated by the Food and Drug Administration (FDA); therefore I need to tell patients that they are completely safe." 2. "They are natural products and therefore are safe as long as you use them for the conditions that are indicated." 3. "These preparations are covered by insurance, including Medicare, Medicaid, and private payers." 4. "We need to treat herbal preparations as though they are "drugs" because many have active ingredients that can interact with other medications and change physiological responses."

4. "We need to treat herbal preparations as though they are "drugs" because many have active ingredients that can interact with other medications and change physiological responses."

Meditation may compound the effects of which of these medications? 1. Prednisone and antibiotics 2. Insulin and vitamins 3. Cough syrups and aspirin 4. Antihypertensive and thyroid-regulating medications

4. Antihypertensive and thyroid-regulating medications

When planning patient education, it is important to remember that patients with which of the following illnesses often find relief in complementary therapies? 1. Lupus and diabetes 2. Ulcers and hepatitis 3. Heart disease and pancreatitis 4. Chronic back pain and arthritis

4. Chronic back pain and arthritis

A patient who has been using relaxation wants a better response. The nurse recommends the addition of biofeedback. What is the expected outcome related to using this additional modality? 1. To eat less food 2. To control diabetes 3. To live longer with acquired immunodeficiency syndrome (AIDS) 4. To learn how to control some autonomic nervous system responses

4. To learn how to control some autonomic nervous system responses

allopathy (biomedicine)

Western or conventional medicine; focuses on physical problems, identifying diseases and conditions by a physician or other healthcare provider by using drugs and surgery to treat ailments

guided imagery

a gentle but powerful technique that focuses and directs the imagination in order to promote a sense of well-being and relaxation concentrating on an image; positive thoughts; distracts and relaxes (ex=tell me about your favorite place you've vacationed)

complementary and alternative medicine (CAM)

an array of health care approaches with a history of use or origins outside of mainstream medicine

chamomile

anti-inflammatory and calming agent

ginger

antiemetic; used for nausea and vomiting

meditation

any activity that limits stimulus input by directing attention to a single unchanging or repetitive stimulus so the person is able to become more aware of self; relaxes the body and stills the mind

aloe

applied topically to accelerate wound healing

acupressure

applying digital pressure in a specified way on designated points on the body to relieve pain, produce analgesia, or regulate a body function (ex=sea bands)

reflexology

applying pressure to hands or *feet*

the power of nursing "presence"

being there versus being with connecting to other human beings enables growth, alleviating suffering, present as a whole person

garlic

blood thinner

movement therapy

controlled breathing and movement

yoga

focuses on body musculature, *posture*, *breathing mechanisms*, and consciousness; goal is attainment of physical and mental well-being through mastery of body achieved through exercise, holding of postures, proper breathing, and meditation

prayer

has different meaning to different people; may be a conversation with God asking for a divine intervention or a type of meditation that is useful in healing -some people/nurses pray for themselves and also pray for and with others

holistic nursing care

healing the whole person; taking into consideration all aspects of a person's life

physical therapy

integrates a variety of modalities including massage, manipulation, heat and cold, movement, and electrical impulses to treat the body after damage or injury, reduce swelling, relieve pain, and restore function and range of motion

chiropractic medicine

manipulating the spinal column and joints; focusing on spinal alignment for optimal nervous system functioning; includes physiotherapy and diet therapy

massage

manipulation of muscles and soft tissues to improve circulation, muscle tone, improve relaxation, facilitate healing, and reduce stress (using effleurage)

acupunture

one of the oldest practices in the world; a mind-body therapy that regulates the vital energy inserting needles into the skin in specific areas; modifies the response of the body to pain and how pain is processed by central neural pathways and cerebral function

tai chi

originally a martial art that is now viewed as a moving meditation in which patients move their bodies slowly, gently, and with awareness while breathing deeply

qi gong

originally a martial art, now viewed as a series of carefully choreographed movements or gestures that are designed to promote and manipulate the flow of qi within the body

herbal medicines

plant-based therapies used in whole systems of medicine or as individual preparations by allopathic providers and consumers for specific symptoms or issues

saw palmetto

prevents prostatic hyperplasia

aromatherapy

the therapeutic use of plant aromas and essential oils for health treatment; has caused some allergic reactions in some people, so seek guidance from someone who has had professional training

holism

the understand that people are not just physical bodies; people have mental/emotional, spiritual, and relationship aspects involved with well-being that combine within the physical body to make a whole person

Florence Nightingale

thought to be one of the first holistic nurses because she believed in care of the whole person, focusing on unity, body/mind/spirit wellness, and the interrelationship of human beings with their environment not only focused on patients' physical needs and cleaner conditions, but prayer and care of the whole person

therapeutic touch

touch therapy affecting the energy fields that surround and penetrate the human body with the conscious intent to help or heal placing a practitioner's open palms close to the body of the person and focusing on the quality of the qi and areas of energy obstructions, redirecting the energy to harmonize and move

gingki biloba

used by patients with Alzheimer's and dementia; memory improvement (effects are in question)

dietary supplements

used to supplement dietary/nutritional intake by mouth; contain one or more dietary ingredients, including vitamins, minerals, herbs, or other botanical products

music therapy

using music to address needs of individuals with disabilities and illnesses; improves physical movement and/or communication, develops emotional expression, evokes memories, and distracts people who are in pain -use music/sounds to produce desired changes in behaviors, emotions, physiological processes -influences limbic system involved with emotion