Prep U's - Chapter 28 - Complementary & Alternative Therapies

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? A. Disturbed energy field. B. Hopelessness. C. Impaired coping. D. Social isolation.

Answer: A Rationale: Defining characteristics of the disturbed energy field relate to movement, sounds, temperature change, visual changes, and disruption. The aura the client is referring to in this scenario is a vague, luminous glow surrounding something that may be an information-containing electromagnetic field, which can be likened to the data contained within a computer. Social isolation would refer to a client who is feeling isolated from others. Impaired coping refers to a client who is having difficulty dealing with a particular situation. Hopelessness refers to a client who feels there is no hope for improvement from an illness or in life in general.

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 addressing the client's problem? A. lavender B. ginger C. lemon D. peppermint

Answer: A Rationale: For insomnia, lavender is appropriate. Ginger, peppermint, and lemon are helpful in controlling nausea.

A nurse is educating a client on meditation techniques to provide mental calmness and physical relaxation. Which nursing intervention facilitates this process? A. helping the client to assume a specific, comfortable posture. B. teaching the client to have multiple focal points. C. promoting a closed attitude to avoid judgments and distractions. D. providing a stimulating environment in which to conduct the meditation.

Answer: A Rationale: Meditation requires a specific, comfortable posture so that a single focal point can easily be established. Depending on the type being practiced, meditation can be done while sitting, lying down, standing, walking, or in other positions. The environment must be quiet, rather than stimulating, in order for meditation to be effective. The client must have an open attitude to avoid judgments and distractions.

The nurse is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first? A. Requesting the client's permission to touch the body. B. Embracing the client for energy. C. Moving the hands 2 to 6 in (5 to 16 cm) away from the client's skin surface. D. Calling to rebalance the soul.

Answer: A Rationale: Prior to touching the client, the nurse should request permission and explain the process of therapeutic touch. All other interventions would be performed after this occurs.

A client's family member asks the nurse if he or she may bring essential oils for use in the hospital room for the client. What action should the nurse take? A. Provide education and determine if there is a sensitivity to the oils. B. Refuse the use of essential oils in the client's room, because they may be a hazard. C. Inform the client and family that all essential oils are the same. D. Tell the family member that essential oils are not proven to be effective treatment.

Answer: A Rationale: The essential oils of plants can be used as a therapy to improve physical, emotional, and spiritual well-being. The fragrance of these oils is believed to ultimately affect the very sensitive amygdala of the limbic system in the brain, where emotional memories are stored and released. Laboratory and animal studies have shown that certain oils have antibacterial, antiviral, antifungal, calming, and energizing effects. Commonly used essential oils in a health care setting are ginger or peppermint for nausea and lavender or chamomile for insomnia. Essential oils vary in quality and potency depending on the manufacturing processes. If specific essential oils are approved for use in an inpatient setting, the nurse provide education on these oils. Some people are highly sensitive to strong fragrances, particularly concentrated essential oils. This might preclude their use for specific clients.

Which is the most important role of the nurse in using complementary and alternative therapies? A. Educating the public about safety and effectiveness. B. Practicing guided imagery prior to surgery. C. Providing nutrition supplements for weight gain. D. Administering herbal supplements for anxiety.

Answer: A Rationale: The most important role of the nurse in using CAT is educating the public about the safety and effectiveness of using the therapies. Administering herbal supplements for anxiety and providing nutrition supplements for weight gain may be considered part of a treatment plan but they are not the most important aspects of CAT. Guided imagery is one aspect of treatment included in CAT.

Why is Zen meditation effective for a client with generalized anxiety disorder? A. Assists client to enter state of calmness. B. Helps client forget issue causing stress. C. Used to reduce hyperactivity in group therapy. D. Includes yoga exercise for stress relief.

Answer: A Rationale: Zen meditation assists the client to enter a state of calmness to reduce anxiety. Focusing on breathing, posture, and the present, allows the mind to deal properly with intrusive thoughts, bringing a sense of calmness over oneself. Zen meditation doesn't make one forget about stressful thoughts, rather how to manage them effectively. Zen, or mindfulness meditation, is not a group therapy for hyperactivity, Although Yoga and Zen meditation have many similarities, Zen focuses on achieving a higher consciousness.

A client asks the nurse about the use of healing touch. Which statement regarding healing touch is accurate? A. Healing touch is too expensive for most clients. B. Supplemental music is used during healing touch. C. Aromatherapy is used in healing touch. D. Healing touch does not use injections.

Answer: D Rationale: Healing touch has been shown to be effective in helping clients relax and improve the healing process. It is not expensive because it involves no special equipment, including insertion of tubes or injections. Aromatherapy and supplemental music are not routinely used in healing touch.

A nurse practitioner is conducting a presentation at a local community center about complementary health approach. One of the participants asks the nurse practitioner, "Everybody is talking about relaxation. Just how does relaxation help a person?" The nurse responds, integrating which effect as being associated with relaxation? Select all that apply. A. Reduced muscle tension. B. Better sleep and rest. C. Improved sense of well-being. D. Less anxiety. E. Lowered immune response.

Answer: A, B, C, D Rationale: Relaxation can be useful whether a client is experiencing a single stressful event, such as surgery, or chronic stress. Client benefits include reduced anxiety, reduced muscle tension and pain, improved functioning of the immune system, enhanced sleep and rest, and an improved overall sense of well-being.

The nurse is working with a client recently diagnosed with cancer. The client says, "I found this product that I want to use to fight my cancer." Which statements in the product literature should raise suspicion in the nurse? Select all that apply. A. The pharmaceutical industry is trying to hide information about the product. B. It cites personal testimony from a user that it cured her cancer. C. It claims to be an "all-natural" product. D. Vitamins and minerals are listed in the ingredients. E. It contains a secret ingredient known only to the manufacturers.

Answer: A, B, C, E Rationale: Dietary supplements that are "rip-offs" often claim that one product does it all, use personal testimonials as evidence of success, are "all-natural," claim to be a "miracle cure," and claim that the pharmaceutical industry and government are trying to hide information about the product. A product that has vitamins and minerals in the ingredients may be a legitimate method of strengthening the client's nutrition, which will help in cancer treatment.

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. A comfortable position. B. An open attitude. C. Use of music. D. A quiet location. E. A dark room.

Answer: A, B, D Rationale: The use of meditation involves four elements, which include an open attitude, a quiet location, and a comfortable position; all of these contribute to the ability to relax when performing meditation. Use of music and a dark room are not routinely associated with meditation.

A client presents to the clinic with a sprained left wrist. The health care provider suggests alternative therapy. What education will the nurse provide to the client? Select all that apply. A. Physical exercises. B. Guided imagery. C. Rest and fluids. D. Anti-inflammatory diet. E. Meditation.

Answer: A, B, D, E Rationale: Rest and fluids are an alternative therapy for the common cold rather than a musculoskeletal injury. The other selections are all good choices for alternative therapy for the injury.

The nurse is providing client education about the use of herbal medicines. Which statements are accurate? Select all that apply. A. They can be toxic in high doses. B. They are regulated by the government. C. They contain certain amounts of active ingredients. D. They take longer to produce a therapeutic effect. E. They all can safely be taken with other medications.

Answer: A, C, D Rationale: Herbal medicines do take longer to produce a therapeutic effect, can be toxic in high doses, and do contain certain amounts of active ingredients. They are not regulated by the government and many cannot be safely taken with other medications.

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. A. The nurse teaches the client how to meditate. B. The nurse administers pain medication prescribed by the primary care provider. C. The nurse uses guided imagery to relieve client anxiety. D. The nurse investigates herbs that may stimulate the client's immune system. E. The nurse schedules diagnostic tests for the client. F. The nurse encourages a client to join a yoga class.

Answer: A, C, D, F Rationale: The term complementary and alternative medicine refers to interventions that are complementary therapies (CAM—they can be used with traditional medical interventions and thus complement them) as well as alternative modalities (not included in the scope of conventional medical care). Herbal remedies, yoga, meditation, and guided imagery are all forms of CAM. Administering pain medication and scheduling diagnostic tests are traditional allopathic (biomedicine) therapies.

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. A. Comfortable position B. Closed attitude. C. Massaging abdomen D. Focus of attention E. Quiet environment

Answer: A, D, E Rationale: There are four elements common to most types of meditation: comfortable position, quiet environment, focus of attention, and open attitude. Closed attitude and massaging abdomen are not elements of meditation.

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? A. Physiotherapy B. Acupuncture C. Allopathy D. Therapeutic Touch (TT)

Answer: B Rationale: Acupuncture is based on energy regulation of qi through meridians. It is a core principle in traditional Chinese medicine. Therapeutic Touch (TT) is not a form of traditional Chinese medicine and is based on the consciously directed process of energy exchange. Physiotherapy and allopathy are not based on the concept of qi.

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? A. Ayurveda B. Allopathic C. Naturopathy D. Traditional Chinese medicine.

Answer: B Rationale: Allopathic medicine (or conventional medicine) is evidence-based practice that includes remarkable advances in biotechnology, surgical interventions, pharmaceutical approaches, and diagnostic tools. Allopathic medical care is particularly effective when aggressive treatment is needed in emergency or acute situations. Traditional Chinese medicine uses eight principles to analyze symptoms and categorize conditions, and uses the theory of five elements to explain how the body works. Naturopathy involves the belief that health is a dynamic state of being that provides abundant energy for people to deal with life in our complex society. Ayurveda involves the integration and balance of the body, mind and spirit.

The nurse explains to the client which statement is true regarding the difference between allopathic therapy and complementary and alternative therapy? A. Allopathic therapy integrates mind and body. Complementary and alternative therapy separates mind and body. B. Allopathic therapy emphasizes treatments for diseases. Complementary and alternative therapy emphasizes treatments for health. C. Allopathic therapy uses herbs to treat. Complementary and alternative therapy uses medications to treat. D. Allopathic therapy is the absence of illness. Complementary and alternative therapy states health is the imbalance of the body systems.

Answer: B Rationale: Allopathic therapy emphasizes treatments for diseases using traditional western medicine provided by an MD or DO. Examples of Allopathic therapy include pharmacotherapy, surgery, and radiology. Alternative medicine and complimentary medicine are terms that describes medical treatments that are used instead of traditional western therapies. Examples of complementary therapy include acupuncture, aromatherapy, homeopathy, and yoga. Alternative therapy includes acupuncture, homeopathy, and eastern oriental practices.

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? A. Peppermint B. Chamomile C. Ginger D. Almond

Answer: B Rationale: Chamomile is used as aromatherapy for insomnia. Peppermint, almond, and ginger have uses as aromatherapy but are not used for insomnia.

Allopathic therapy integrates mind and body. Complementary and alternative therapy separates mind and body. A. Cedarwood B. Ginger C. Chamomile D. Lavender

Answer: B Rationale: Ginger or peppermint is an appropriate essential oil choice for addressing nausea. Chamomile, lavender, and cedarwood are used for insomnia.

A client asks the nurse about taking herbal medications. Which of these is the nurse's best response regarding safety of the herbal medications? A. "Herbal medications are natural products so there are not side effects with these." B. "Name brand products with herbal medications usually are of higher quality." C. "You can take combination products to save money on these medications." D. "Your effects from herbal medications are quicker than with traditional medicine."

Answer: B Rationale: Name brand products with herbal medications tend to be of higher quality so can be best to choose since the industry is not regulated by federal agencies. Herbal medications can have side effects, and many times work slower than traditional medications do, so clients should give them time to help and observe for any side effects. Single products are best, particularly if there are side effects; if there are combinations of medications, it is difficult to tell which caused a problem.

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? A. Activates natural pleasure centers. B. Helps to increase the effects of parasympathetic nervous system on the mind and body. C. Slows circulation throughout the body. D. Increases the body's natural immunity.

Answer: B Rationale: Relaxation techniques promote parasympathetic nervous system activity, helping to reduce sympathetic activity and restore the balance of the two systems. The ultimate goal is to increase the parasympathetic system influence in the mind-body and thus reduce the effect of stress and stress-related illness on the body. Natural products can boost the body's immunity. Energy healing activates natural pleasure centers. Hands-on techniques such as massage promote circulation throughout the body.

A nurse is teaching an overweight client the holistic approach to choosing foods. Which teaching points would the nurse include? Select all that apply. A. Avoid organically grown foods. B. Replace refined sugars with artificial sweeteners. C. Eat foods that are in season. D. Reduce intake of refined and natural sugars. E. Increase intake of dairy products. F. Consider adopting a vegetarian diet.

Answer: B, C, D Rationale: Eating foods that are in season is suggested because foods produced "out of season" are treated with chemicals to ripen them since they are picked before ripening. Reducing the intake of refined and natural sugars is best because of the negative effects of these substances. A vegetarian diet can be beneficial because animals are increasingly fed antibiotics and potentially contaminated foods. Also, increasingly, fish are being contaminated with mercury and other pollutants.

Ayurvedic medicine has its roots in which of the following areas? A. Southeast Asia B. Japan C. India D. China

Answer: C Rationale: Ayurvedic medicine has its roots in India.

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? A. Sugar increases natural bacterial flora in the GI tract. B. Sugar assists with cellular absorption of nutrients. C. Excess sugar increases demand on the pancreas. D. Healthy amounts of sugar are usually consumed.

Answer: C Rationale: Excess sugar increases demand on the pancreas; therefore, less sugar should be consumed. The client who has diabetes mellitus type 2 may have a compromised pancreas. Further stress to the pancreas can cause further injury to the organ.

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 addressing the client's nausea? A. Cedarwood B. Lavender C. Ginger D. Chamomile

Answer: C Rationale: Ginger or peppermint is an appropriate essential oil choice for addressing nausea. Chamomile, lavender, and cedarwood are used for insomnia.

The mind and body are connected in the provision of care. This statement describes: A. allopathic care. B. homeopathic care. C. altruistic care. D. holistic care.

Answer: D Rationale: Holistic interventions focus on the interrelated needs of body, mind, emotions, and spirit.

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? A. Document the observations and encourage the client that he or she will feel better once going home. B. Suggest the client try some meditation and contact the health care provider to request medication to help with sleep. C. Ask the client's family to bring some items from home, such as a blanket, pillow, or pictures. D. Reassure the client how lucky he or she is to have family visit often and reassure the client that he or she will be going home soon.

Answer: C Rationale: Holism is a theory and philosophy that focuses on connections and interactions between parts of the whole, as well as the body's interaction with the environment. Holism recognizes that a person's environment and habits are part of who the person is. The holistic model is not necessarily a counterpoint to the biomedical model. While a focus on the mind is congruent with holism, this does not preclude treatment of bodily symptoms. Reassurance and encouragement may seem necessary but are not components in holistic care and can often feel ingenuine to clients. Suggesting meditation may help the client but is not the most appropriate measure.

Which principle does not encompass the basic goals of integrative medicine? A. Focus on promoting health and preventing illness, as well as treating disease. B. Facilitate the body's innate healing abilities. C. Reject allopathic medicine and embrace CAM practices. D. Establish a partnership between client and practitioner.

Answer: C Rationale: Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, spirit, and community), including all aspects of lifestyle. It does not reject allopathic medicine and CAM practices. It includes establishing a partnership between client and practitioner, facilitating the body's innate healing abilities, and focusing on promoting health and preventing illness, as well as treating disease.

For which client might the nurse need to alter the plan of care based on the principles of the client's chosen medical system? A. A client who visits a chiropractor. B. A client who believes in a strong mind-body connection. C. A client who is being treated by a naturopathic health care provider. D. A client who is being treated by an allopathic health care provider.

Answer: C Rationale: Naturopathic medicine is not only a system of medicine but also a way of life, with emphasis on client responsibility, client education, health maintenance, and disease prevention. Clients who are being treated by a naturopathic health care provider will probably have a different plan of care than those being treated by allopathic health care providers. Chiropractic medicine, a body-mind connection approach, and allopathic medicine are more easily incorporated into the traditional plan of care.

A client suffers from chronic pain. The nurse suggests the client have monthly massages. This is an example of: A. allopathic medicine. B. palliative medicine. C. alternative medicine. D. adjuvant medicine.

Answer: C Rationale: The use of conventional therapy as seen with CAM includes the use of herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy.

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? A. allowing accumulated toxins to be released from the body. B. reconnecting the client's body, spirit, and emotions. C. altering the client's perception and acceptance of reality. D. restoring a healthy flow of energy along the meridians of the body.

Answer: D Rationale: Acupuncture either increases or decreases the flow of qi along the meridians of the body. It does not directly address the relationships between body, spirit, and emotions, nor does it aim to release toxins or change an individual's perception of reality.

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? A. Including the client's shaman in the plan of care. B. Basing practice on the yin-yang theory. C. Preparing the client for exercises that help him or her regulate qi D. Helping the client to balance his or her dosha

Answer: D Rationale: Central to Ayurvedic medicine is an understanding of the client's basic constitution, or dosha. The three doshas in Ayurvedic medicine are vata (changeable), pitta (intense), and kapha (relaxed). Yin-yang and qi are associated with traditional Chinese medicine. A shaman is associated with shamanism (involves the spirit world).

A nurse can best help a client who is undergoing chemotherapy and using guided imagery with this by doing which of the following? A. Promoting the client's use of imagery only after a stressful event occurs. B. Explaining to the client that it is not a good idea to record their own imagery tape. C. Helping the client learn about the different poses that can be performed. D. Assisting the client to find an appropriate imagery tape to use.

Answer: D Rationale: Clients use imagery to help with relaxation and this can use all five senses. Many times, clients use a guided imagery tape that includes a script to help with imagery; clients also can record their own tape. Clients do not necessarily use poses with this; this would be more related to use of yoga. Guided imagery can help both during and after a stressful event to help the client relax.

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? A. "You might want to consider the use of botanicals, which can take the place of your prescribed medications." B. "Meditation is the only alternative medicine that is recommended for chronic migraines." C. "Therapeutic Touch balances qi, which is part of vital life force, thus relaxing the muscles and increasing relief of migraine headaches." D. "Acupuncture uses fine needles inserted in the skin to stimulate natural painkillers and has proven to be beneficial in treating chronic migraines."

Answer: D Rationale: Diagnosis in Traditional Chinese Medicine is based in the balance, or lack thereof, of Yin and Yang. Yin and Yang are both aspects of qi, which is considered a vital life force. Acupuncture has been shown to be an effective way to manage chronic migraine headaches. Meditation is not the only therapy that can be used to treat chronic migraines, and Therapeutic Touch is not part of Traditional Chinese Medicine. The nurse should not recommend botanicals in place of prescribed medications.

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? A. "I am just curious on what types of treatments are used by people." B. "I want to make sure you understand all the risks of these treatments." C. "It will help me so that I can recommend use of these for other clients." D. "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.

Answer: D Rationale: Nurses need to include complementary and alternative therapy in assessment of the client's current treatments to ensure an understanding of the safety and effectiveness of the treatments, particularly if the client is also receiving allopathic treatment. The nurse would want to be positive with this questioning so that the client is not defensive regarding any complementary and alternative treatments.

The nurse is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first? A. Embracing the client for energy. B. Calling to rebalance the soul. C. Moving the hands 2 to 6 in (5 to 16 cm) away from the client's skin surface. D. Requesting the client's permission to touch the body.

Answer: D Rationale: Prior to touching the client, the nurse should request permission and explain the process of therapeutic touch. All other interventions would be performed after this occurs.

Which would be the least consistent with the Native American/Canadian Indigenous view of disease? A. Violation of a taboo. B. A result of negative thinking. C. Disharmony with Mother Earth. D. Balance of yin and yang.

Answer: D Rationale: The Native American/Canadian Indigenous view disease as a disharmony with Mother Earth, a result of negative thinking, or violation of a taboo. Chinese medicine proposes that health is the outcome of balancing yin and yang.

Which is the most important role of the nurse in using complementary and alternative therapies? A. Providing nutrition supplements for weight gain. B. Practicing guided imagery prior to surgery. C. Administering herbal supplements for anxiety. D. Educating the public about safety and effectiveness.

Answer: D Rationale: The most important role of the nurse in using CAT is educating the public about the safety and effectiveness of using the therapies. Administering herbal supplements for anxiety and providing nutrition supplements for weight gain may be considered part of a treatment plan but they are not the most important aspects of CAT. Guided imagery is one aspect of treatment included in CAT.

According to survey results, who are the most prevalent users of complementary or alternative therapies? A. Women, ages 25-40, with high school degree, who smoke. B. Men, ages 30-45, with college degree, who recently stopped smoking. C. Men, ages 50-65, with some high school, who smoke. D. Women, ages 35-50, with college degree, former smokers.

Answer: D Rationale: The most prevalent users of CAT are women, ages 35-50, with higher levels of education, who are former smokers.