Wk 10- Complementary and Alternative Medicine

The nurse is caring for a patient with deep vein thrombosis who is on anticoagulant therapy. Which instruction should the nurse give the patient?

"Avoid eating large amounts of garlic." A patient who is on anticoagulant therapy should avoid eating garlic beyond the small amount needed for seasoning because garlic also has an anticoagulant effect and may increase the risk for bleeding. Ginger, peppermint, and chamomile do not have anticoagulant properties. Ginger helps to treat migraine headaches and also stimulates the immune system. Peppermint helps in the treatment of bowel disorders. Chamomile tea is effective in treating gastrointestinal problems.

The nurse is providing education to a group of patients interested in complementary medicine. Which teaching point should the nurse include as priority education for the group?

"Confirm with your healthcare provider that any herbs you take will not interact with prescribed medications." The highest priority teaching point is that the patient should seek education and confirm with a healthcare provider that any herbs taken will not have an adverse effect if taken with prescribed medications.

The nurse is teaching a patient about the benefits of soy. Which patient statement confirms that the patient understands the benefits of soy?

"Soy might help me with hot flashes." Soy protein and soy isoflavones have several uses including prevention of breast cancer and, in postmenopausal women, treatment of hot flashes and prevention of osteoporosis. St. John's wort is used to treat mild depression. There are no contraindications to eating meat and taking soy. Soy should not be combined with tamoxifen and other drugs that can block estrogen receptors.

The nurse is interviewing a patient who has chronic obstructive pulmonary disease (COPD). The patient wants to use herbal medications rather than conventional medications to treat a cold. Which statement made by the nurse is appropriate?

"You should discuss any plans to take herbal medications with your primary healthcare provider." Herbal drugs, as conventional drugs, may interact with drugs being taken for a number of conditions and/or may worsen those conditions, so decisions should be made in consultation with the primary care provider. Most herbal medications are available at a lower cost because of the low cost of production. Overall, herbal medications tend to be less expensive than conventional medications. Herbal supplements are made from natural substances, so they have fewer side effects compared to conventional medications. Herbal medications are supplied without a prescription.

The nurse is reviewing the chart of a patient with human immunodeficiency virus infection. Which piece of data would alert the nurse to follow up?

Echinacea supplement The information indicates that the patient is immunocompromised. Because echinacea acts by suppressing the immune system, it should not be given to this patient.

The patient asks the nurse for a supplement that can be used to prevent motion sickness during a vacation cruise. The nurse suggests which supplement?

Ginger root (Zingiber officinale) Ginger root is used to suppress nausea and vomiting caused by motion sickness and morning sickness and for postoperative nausea and vomiting. It may be involved in the blockade of serotonin receptors located in the chemoreceptor trigger zone of the brain. Garlic, coenzyme Q-10, and feverfew are not used to suppress nausea and vomiting.

Which product did the U.S. Food and Drug Administration (FDA) ban in the United States because of the serious adverse effects of myocardial infarction, stroke, and death?

Ma huang (Ephedra) Sales of ma huang have been banned in the United States since 2004 making it the first time that a dietary supplement has been ordered off the market. It has been associated with stroke, myocardial infarction, and death. The ban was challenged in 2007, but a rehearing petition was denied. Valerian, St. John's wort, and saw palmetto are currently available for sale in the United States.

A patient is taking ma huang for weight loss. What life-threatening adverse effects should the nurse teach the patient about this herbal remedy?

Myocardial infarction Ma huang (ephedra) contains ephedrine, a compound that can elevate blood pressure and stimulate the heart and central nervous system. High doses of ephedra have been associated with stroke, myocardial infarction, and death. Intestinal problems have not been substantiated. Anaphylaxis is an allergic response.

Which statement is found in the Dietary Supplement Health and Education Act (DSHEA) of 1994?

No proof of efficacy is required for dietary supplements. According to the Dietary Supplement Health and Education Act (DSHEA) of 1994, no proof of efficacy is required for dietary supplements because they are considered to be safe. In contrast to this, proof of efficacy is required for legend drugs and over-the-counter drugs. These drugs have a narrow therapeutic index when compared to dietary supplements. Prescription is not required for selling and supplying dietary requirements to patients because they have a greater margin of safety.

During the assessment process, the patient reports using oral comfrey for the treatment of acne. What should the nurse teach the patient about the adverse effects of comfrey?

Severe liver damage can occur. Comfrey contains pyrrolizidine alkaloids, which can cause veno-occlusive disease (VOD) in animals and hepatic VOD in humans. Hepatic VOD can result in severe liver damage. GI disturbances, headaches, and urinary tract infections are not adverse effects of comfrey use.

A patient who has depression is admitted to the emergency department with serotonin syndrome. The nurse learns that the patient is taking an herbal medication and citalopram [Celexa]. Which herbal medication is the patient most likely taking?

St. John's wort St. John's wort is an herb used as a medication to treat depression. It leads to serotonin syndrome when administered with other selective serotonin reuptake inhibitors, such as citalopram [Celexa]. Valerian causes central nervous system depression when used with sedatives. Saw palmetto changes the effects of hormones in oral contraceptive drugs or hormonal replacement therapies. Cranberry decreases the elimination of many medications excreted by the kidneys.

Which information on the product label of an herbal supplement would comply with the regulations established by the Dietary Supplement Health and Education Act (DSHEA)?

Supports the immune system The DSHEA restricts the wording of labels on product packaging. A label cannot claim to diagnose, treat, cure, or prevent disease. However, the label is allowed to state the product's ability to favorably influence body function or structure. Statements on a label such as "reduces pain of arthritis," "lowers cholesterol," and "relieves menopausal hot flashes" would not be in compliance with DSHEA regulations.

The nurse is reviewing the chart of a female patient who is scheduled for a hip replacement. Based on the chart information, what information about black cohosh will the nurse share with the patient?

Taking antihypertensives and black cohosh can cause hypotension. Black cohosh may potentiate the hypotensive effects of antihypertensive drugs as well as the hypoglycemic effects of insulin and other drugs for diabetes. In women under anesthesia, the herb has caused hypotension that was difficult to manage. There are no known interactions between black cohosh and CNS depressants or orange juice.

A patient is admitted with multiple bruises over the arms and legs. What should be the nurse's first action?

To ask the patient for a list of medications and herbal supplements The nurse should first assess before acting. Medications as well as supplements can cause a patient to be susceptible to bruising. The other actions would occur after assessment.

A patient who has inflammation of the liver has tenderness in the upper right abdomen and yellowish discoloration of the skin and sclera. After checking the patient's history, the nurse finds that the patient has been taking kava, an herbal drug, for a long time. What should the nurse teach the patient?

To stop using kava The patient has inflammation of the liver due to the use of kava. Prolonged use of kava may lead to liver toxicity; therefore, its use should be prevented. The use of acetaminophen [Tylenol] should also be discontinued because it can cause liver toxicity. Dextromethorphan [DXM] is used as a cough suppressant. Other herbal drugs may have side effects and should not be used unless cleared by the primary healthcare provider.