Chapter 28 Complementary and Alternative Therapies
When obtaining information for a database, which of the following represents a nurse commitment and interest in reflected integrative medicine (CAM)? "Which prescription medications do you take daily?" "Which diseases do you suffer from and what are your allergies?" "Which types of foods do you consume in 24 hours?" "Do you take any vitamins or minerals, and if so, what?"
"Do you take any vitamins or minerals, and if so, what?" Starting with the initial contact with a client, the nurse includes a basic assessment of the client's use of CAM in an intake interview. The nurse asks about vitamins and supplements as well as any healing practices. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 809.
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'll reduce the amount of processed foods I eat." "Frozen foods are better to eat than canned foods." "I can have a can of soda as often as I want to." "Natural sweeteners are better to use than artificial ones."
"I can have a can of soda as often as I want to." The client needs more instruction based on the statement about having a soda whenever desired. Soft drinks are "fake food" and have no nutritional value. Reducing the amount of processed food, such as using frozen over canned foods and using natural sweeteners, reflects understanding of the teaching. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, Nutritional Therapy, Teaching Tips 28-2, p. 811.
A patient with dermatitis has sought care from a homeopathic practitioner seeking treatment for dry, itchy, and inflamed skin. Which statement is characteristic of homeopathy? "This is not simply a skin problem, but rather a spiritual problem that is manifesting itself in your skin." "This skin problem is actually indicative of blocked energy in your body; I'm going to teach you how to relax deeply." "I'm going to recommend a diluted solution that is derived from poison ivy." "I'm going to provide you with an herbal balm that is based on the aloe vera plant."
"I'm going to recommend a diluted solution that is derived from poison ivy." Homeopathic practice is based on two fundamental laws. The Law of Similars states that a natural substance that produces a given symptom (such as pruritus) in a healthy person will cure it in a sick person. The Law of Infinitesimals states that the smallest dose possible (such as highly diluted preparation) will have the desired effect. Homeopathy does not prioritize the spiritual dimension of illness, herbal remedies, or the flow of energy. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 812.
A client comes to the clinic for a routine visit. During the interview, the client tells the nurse, "I'd really like to try to use some herbs and supplements to stay healthy. Do you have any suggestions for what I should do?" Which response by the nurse would be appropriate? Select all that apply. "Try using products that are combinations of several ingredients." "Make sure to understand what you are taking and the reason why." "The label lists the minimum you should take, so doubling up would be okay." "Learn about the product you are planning to use." "Use products from reputable companies that have tested their quality."
"Use products from reputable companies that have tested their quality." "Make sure to understand what you are taking and the reason why." "Learn about the product you are planning to use." When using herbs and supplements, the client should get information from knowledgeable and reliable sources; buy products that are produced by reputable companies; buy products that include label logos that identify dietary supplements and herbals that have been tested for ingredient quality and contaminants. Whenever possible, the client should buy single products and follow the label instructions. Clients need to be knowledgeable about the product and reason for using it. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, Botanicals (Herbal Products) and Nutritional Supplements, Teaching Tips 28-1, p. 809."
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? Allopathy Physiotherapy Acupuncture Therapeutic Touch (TT)
Acupuncture 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. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 806.
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. 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. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 804.
A client comes to the clinic for an evaluation. The client reports that "I been having such problems with getting to sleep and then staying asleep. But I don't want to take any medicines." After a discussion of possible complementary health approaches, the client decides to try aromatherapy. Which essential oil would the nurse most likely suggest to address the client's problem? Lemon Peppermint Ginger Chamomile
Chamomile For insonmia, chamomile would be appropriate. Ginger, peppermint, or lemon would be helpful in controlling nausea. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, Aromatherapy, p. 808.
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. Focus of attention Closed attitude Quiet environment Massaging abdomen Comfortable position
Comfortable position Quiet environment Focus of attention 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. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 803.
There are four primary scientific principles for Therapeutic Touch (TT). Which is not one of these principles? A human being is an open energy system. Distractions of modern life interfere with healing agents. Illness is an imbalance in an individual's energy field. A human being is bilaterally symmetrical.
Distractions of modern life interfere with healing agents. The four primary scientific principles of therapeutic touch are: (1) a human being is bilaterally symmetrical; (2) a human being is an open energy system; (3) illness is an imbalance in an individual's energy field; and (4) human beings have natural abilities to transform and transcend their conditions of living. The idea that distractions of modern life interfere with healing agents is a Native American/First Nations belief and is not related to therapeutic touch. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 808.
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? Chamomile Cedarwood Lavender Ginger
Ginger Ginger or peppermint is an appropriate essential oil choice for addressing nausea. Chamomile, lavender, and cedarwood are used for insomnia. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, Aromatherapy, p. 808.
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? Activates natural pleasure centers Helps to increase the effects of parasympathetic nervous system on the mind and body Increases the body's natural immunity Slows circulation throughout the body
Helps to increase the effects of parasympathetic nervous system on the mind and body 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. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, Relaxation, p. 811.
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? Integrative care Homeopathy Holism Complementary therapy
Holism Holism is a theory and philosophy that focuses on connections and interactions between parts of the whole. Complementary therapy can be used to complement traditional medical interventions. Integrative care often incorporates sharing the responsibility in coordinating the best possible treatment plan for a client, including the client's choices for care and the provider's expertise. Homeopathy is based on the belief of supporting the body while the symptoms are allowed to "run their course." Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 797.
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 Medical system perspective Allopathic perspective Integrative perspective
Holism perspective The instructor is describing the definition of holism. Integrative perspective is combining allopathic and complementary and alternative therapy (CAM). The medical system perspective is based on a philosophy and theory about health and illness along with specific types of treatment that may be based in culture. The allopathic perspective is based in biomedicine. Holism is the only perspective that is looking at parts interacting with each other and the environment. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 797.
The mind and body are connected in the provision of care. This statement describes: altruistic care. homeopathic care. allopathic care. holistic care.
Holistic Care Holistic interventions focus on the interrelated needs of body, mind, emotions, and spirit. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 797.
Ayurvedic medicine has its roots in which of the following areas? China Japan Southeast Asia India
India Ayurvedic medicine has its roots in India. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 810.
The practitioner is working with structures and systems within the human body, including the bones, muscles, joints, and circulatory system. Which one of the complementary and alternative therapy domains is being used? Manipulative and body-based practice Energy medicine Mind and body medicine Biologically based practice
Manipulative and body-based practice Manipulative and body-based practice is working with structures and systems within the human body, including the bones, muscles, joints, and circulatory system. Mind and body medicine enhances the mind's ability to control bodily functions. Energy medicine is utilization of energy fields. Biologically based practice uses botanicals and animal-based products for healing. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 809.
A nurse who "unblocks" and "clears" congested areas of energy in a client's body to promote comfort is applying the phenomenon known as: "Unruffling" touch Therapeutic Touch (TT) Tactile manipulation Interpersonal touch
Therapeutic Touch (TT) Therapeutic Touch (TT) involves "unruffling," or clearing, congested areas of energy in the body and redirecting this energy. After assessing a client's "energy field," the nurse uses therapeutic touch to promote comfort, relaxation, healing, and a sense of well-being. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 808.
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 if used by the client would be a cause for concern? Guaifenesin Warfarin Azithromycin Acetaminophen
Warfarin Ginkgo biloba, the most widely sold herb in Europe and used by many to improve memory, affects platelet function and thus should not be used concurrently with warfarin or aspirin. It apperars that acetaminophen, guaifenesin, and azithromycin would not be a concern. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, Botanicals (Herbal Products) and Nutritional Supplements, p. 809.
According to survey results, who are the most prevalent users of complementary or alternative therapies? Women, ages 35-50, with college degree, former smokers Men, ages 50-65, with some high school, who smoke Women, ages 25-40, with high school degree, who smoke Men, ages 30-45, with college degree, who recently stopped smoking
Women, ages 35-50, with college degree, former smokers The most prevalent users of CAT are women, ages 35-50, with higher levels of education, who are former smokers. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 799.
A nurse cares for patients in a chiropractic office. What patient education might this nurse perform? Select all that apply. Applying heat or ice to an extremity Explaining the use of electrical stimulation Teaching a patient relaxation techniques Teaching a patient about a prescription Explaining an invasive procedure to a patient Teaching about dietary supplements
a, b, c, f. 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 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. "CHA proponents believe the mind, body, and spirit are integrated and together influence health and illness." "CHA proponents believe that health is a balance of body systems: mental, social, and spiritual, as well as physical." "Allopathy proponents believe that the main cause of illness is an imbalance or disharmony in the body systems." "Curing according to CHA proponents seeks to destroy the invading organism or repair the affected part." "The emphasis is on disease for allopathic proponents and drugs, surgery, and radiation are key tools for curing." "According to CHA proponents, health is the absence of disease."
a, b, e. 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 is caring for a patient who has crippling rheumatoid arthritis. Which nursing intervention best represents the use of integrative care? The nurse administers naproxen and uses guided imagery to take the patient's mind off the pain. The nurse prepares the patient's health care provider-approved herbal tea and uses meditation to relax the patient prior to bed. The nurse administers naproxen and performs prescribed range-of-motion exercises. The nurse arranges for acupuncture for the patient and designs a menu high in omega-3 fatty acids.
a. 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.
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 patient who is anxious about residual pain from cervical spinal surgery A patient who is experiencing abdominal discomfort A patient who has chronic pain from diabetes A patient who has frequent cluster headaches
a. 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.
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? "Right now you should concentrate on relaxing and taking your blood pressure medicine regularly, instead of worrying about doing yoga." "There is a slower-paced yoga called Kripalu that focuses on coming into balance and relaxation that you could look into." "Ashtanga yoga is a gentle paced yoga that would help with your breathing and blood pressure." "Yoga is contraindicated for patients who have had a heart attack."
b 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 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. Treating the symptoms of the disease Providing patient education Focusing on treating individual body systems Making appropriate interventions to prevent illness Believing in the healing power of nature Encouraging patients to take responsibility for their own health
b, d, e, f. 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.
A nurse working in a long-term care facility incorporates aromatherapy into her practice. For which patient would this nurse use the herb ginger? A patient who has insomnia A patient who has nausea A patient who has dementia A patient who has migraine headaches
b. 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? CHAs are safe interventions used to supplement traditional care. Many patients use CHA as outpatients but do not wish to continue as inpatients. Many nurses are expanding their clinical practice by incorporating CHA to meet the demands of patients. Most complementary and alternative therapies are relatively new and their efficacy has not been established.
c. 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? Teach the patient to always lie down in a comfortable position during meditation. Teach the patient to focus on multiple problems that the patient feels demand attention. Teach the patient to let distractions come and go naturally without judging them. Teach the patient to suppress distracting or wandering thoughts to maintain focus.
c. 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.
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? Acupuncture TT Botanical supplements Guided imagery
d. 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.
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 altering the client's perception and acceptance of reality reconnecting the client's body, spirit, and emotions allowing accumulated toxins to be released from the body
restoring a healthy flow of energy along the meridians of the body 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. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 28: Complementary and Alternative Therapies, p. 806.