Chapter 32: Complementary, Alternative, and Integrative Therapies

In selecting alternative therapies, the nurse recognized that therapeutic touch may be most effective with a:

A. Premature infant

B. Headache sufferer

C. Pregnant woman

D. Psychiatric client

B

Studies have found that therapeutic touch is effective in reducing headache pain.

Premature infants, sensitive to energy repatterning, may need to avoid therapeutic touch. Psychiatric disorders or physically abused may misinterpret the intent & may feel threatened & anxious.

The client asks the nurse about different herbal therapies that may promote physical endurance & reduce stress. Based on the client's request, the nurse provides information on:

A. Ginseng

B. Ginger

C. Echinacea

D. Chamomile

A

Ginseng is believed to have an effect of increased physical endurance, balancing of the body, & increasing resistance to stress.

Ginger = effects as an antiemetic; Echinacea = stimulation of immune system & anti-inflammatory & antibacterial agent; Chamomile = anti-inflammatory, antispasmodic, & anti-infective effect.

The nurse is preparing a presentation on alternative therapies for a community group. The nurse should identify that herbal therapies are:

A. Approved by the Food & Drug Admin., under the Food, Drug, & Cosmetic Act.

B. Sold as medicines in most stores because they lack major side effects.

C. Allowed to be packaged as dietary supplements if they are without health claims.

D. Consistent in their standards for concentrations of major ingredients & additives.

C

The Dietary Supplement Health & Education Act passed in 1994 allows herbs to be sold as dietary supplements if there are no health claims written on labels. Herbal medicines have not undergone rigorous testing; therefore, majority have not received approval for use as drugs. Many herbal medicines are sold as foods because they do not have FDA approval.

The nurse recognized that which one of the following statements is CORRECT concerning complementary & alternative medicine?

A. One third to one half of the U.S. population uses one or more forms of alternative therapy.

B. Insurance coverage is available at the same amount as for traditional medicine.

C. Use of alternative therapies is still not incorporated into medical journals.

D. Use of alternative therapies is primary by those who are less educated or in a lower socioeconomic group.

A

1/3-1/2 use one or more forms of complementary or alternative medicine.

The nurse is aware of the positive responses that may be obtained with the use of alternative therapies. A benefit that the client can gain from relaxation therapy is a Decrease in:

A. Receptivity

B. Peripheral skin temperature

C. Oxygen consumption

D. Alpha brain activity

C

relaxation is characterized by deceased heart & respiratory rates, decreased blood pressure, oxygen consumption & increased alpha brain activity & peripheral skin temperature.

A cognitive benefit of relaxation = increased receptivity;

In selecting an appropriate alternative therapy, the nurse knows that the client who may benefit the most from the PASSIVE type of relaxation is one who is experiencing:

A. Hypertension

B. Terminal cancer

C. Work-related stress

D. Dysfunctional grieving

B

Passive relaxation is useful for persons for whom the effort & energy expenditure of active muscle contraction lead to discomfort or exhaustion, such as the person with cancer.

In selecting an appropriate alternative therapy, the nurse knows that the client who has Raynaud's disease with intermittent peripheral ischemia may benefit the most from:

A. Relaxation therapy

B. Imagery

C. Biofeedback

D. Acupuncture

C

Biofeedback assists individuals in learning how to control specific autonomic nervous systems responses - Raynaud's= intermittent vasospastic attacks of hands and/or feet.

A nurse needs to be alert to possible negative responses to biobehavioral therapies. Clients who have reacted negatively have most often experienced:

A. Aggressive behaviors

B. Delusions

C. Insomnia

D. Loss-of-control sensations

D

A person who has a strong fear of losing control, or who has experienced sensations of loss of control, may perceive meditation as a form of mind control & thus may be resistant.

A practitioner or client who uses traditional Chinese medicine bases the therapy on the PRIMARY concept of:

A. Yin/yang

B. Meridians

C. Six evil senses

D. Acupoints

A

Chinese = yin/yang represent opposing, yet complementary.

Meridians = channels of energy that run in regular patterns through the body; Six evil senses = external causes of disease; Acupoints= points on body where special needles are inserted to modify perception of pain- healing.

The nurse is preparing to assist the client with meditation & breathing. In preparing to implement this therapy, the first step is to:

A. Position the client

B. Provide a warm environment

C. Have the client close his/her eyes

D. Note areas of tension or pain

A

1st step is position client comfortably.

warm environment & closing eyes not necessary.

During the admission history, the client informs the nurse that she follows a Macrobiotic diet. The nurse knows that the clients diet includes:

A. Increased meats & other proteins

B. A 30%/40%/30% protein/carbo/fat ratio

C. Increased intake of vitamin C & beta-carotene

D. Whole grains, vegetables, & fish

D

Macrobiotic diet predominantly vegan (no animal except fish) & emphasis of grains, veggies & unprocessed foods.

The Zone = 30%/40%/30% Protein/Carb/Fat diet. Orthomolecular = increased Vitamin C 7 beta-carotene.

The client has a history of gastrointestinal problems & has used herbal remedies in the past. The nurse expects that this client will be taking:

A. Chamomile

B. St. Johns wort

C. Echinacea

D. Ginkgo biloba

A

Chamomile= inflammatory diseases or gastro. & Upper respiratory tracts, infections & inflammation or skin and mucous membranes.

St. John's wort = treat mild upper respiratory infections, allergic rhinitis & aid would healing.

Ginkgo biloba = Alzheimer's disease, dementia, eye & heart disease, poor circulation, varicose veins, anxiety, & age-related diseases.

A client at the clinic informs the nurse during an examination that he has been taking Chaparral as an anticancer agent. The client asks if there is any reason why this remedy should not be taken. The nurse responds accurately when telling the client that chaparral:

A. Should not be taken with coffee or other caffeinated beverages.

B. May induce veno-occlusive disease

C. Contains a carcinogenic substance

D. Is associated with liver toxicity

D

Chaparral = herb used for anticancer effect. No proven efficacy & may induce liver toxicity.

The nurse's most informed response to the client's question "What is a Complementary therapy?" would be:

A. Relaxation is an example of complementary therapy.

B. It is an intervention that increases your ability to cope with illness.

C. Massage therapy is complementary to muscle relaxant medications.

D. They are therapies used in addition to what your PCP orders.

D

Complementary therapies are used in addition to conventional treatment by PCP.

The client asks Is there anything else we can do to help control my pain? The nurses most informed suggestion concerning Complementary therapies is:

A. Massage therapy may help; it certainly helped me.

B. Most complementary therapies will help decrease your pain.

C. Have you ever thought about seeing a chiropractor? Manipulation often helps decrease pain.

D. Acupressure uses appropriately applied pressure to specific body points, thus decreasing pain.

D

Acupressure= applying digital pressure on designated points to relieve pain, produce analgesia, or regulate body function.

*Inappropriate to include personal comment.

Which of the following client's is most likely to experience the best response from a Complementary therapy?

A. A 5-yr-old receiving a painful injection

B. A 35-yr-old having a diagnostic spinal tap

C. A 55-yr-old being catheterized Post-surgery

D. A 15-yr-old being casted for a wrist facture.

A

While most complementary therapies are successful with most age groups, most successfully reduced discomfort among Children.

Research currently identifies which of the following as the primary reason nurses do not use complementary therapies?

A. Workloads prevent routine implementation

B. Client reluctance to participate appropriately.

C. General bias regarding effects of the therapies.

D. Lack of education regarding their appropriate uses.

D

Nurses lack of education seems to be a barrier to their use of effective nonpharmacological interventions.

A client is dealing with chronic pain. the nurse suggests implementation of relaxation techniques. The nurses most informed response to the clients question: How is relaxing going to help my pain? would be:

A. What have you got to lose? It could certainly help.

B. It will increase the effectiveness of the pain medication you're taking.

C. Relaxing has been very helpful for people, especially those in severe pain.

D. Relaxing your muscles is a better way for your body to respond to the pain.

D

Complementary therapies teach ways to change their behavior to alter physical responses to stress & improve symptoms of muscle tension, gastro. discomfort, pain, or sleep disturbances.

Which of the following statements, made by a client experiencing anxiety who practices relaxation techniques regularly, requires follow-up by the nurse?

A. I want to share this with my sister; her life is stressful, too.

B. Relaxation gives me a sense of being in control of my anxiety.

C. Relaxation helps me feel less physically tense so my blood pressure is lower.

D. If I practice relaxation techniques often enough, I won't need my antianxiety medications anymore.

D

Complementary therapies are used in addition to conventional treatment recommended by PCP. They do not replace the prescribed treatment plan.

A client diagnosed with hypertension & diabetes shares with the nurse that he has been using meditation to deal with the chronic pain he experiences from an old back injury. Which of the following questions shows the best understanding of the effects of medication on the client's Systemic functions?

A. How many times a day do you meditate?

B. Have you monitored your blood pressure lately?

C. Have you had any improvement with your pain?

D. Are you currently taking blood pressure medication?

D

Meditation may increase effects of certain drugs for example: those taking antihypertensive or thyroid-regulating, antidepressant, or antianxiety medications.

A nurse & client are engaged in imagery training. The nurse shows the best understanding of the importance of selecting an appropriate focus when stating:

A. Lets discuss how to select todays focus.

B. Todays focus will be auditory rather than visual.

C. What do you find to be most effective as your focus?

D. Review this list & select a focus for todays session>

C

People typically respond to their environment according to the way they perceive it by their own visualization & expectations. Therefore, they learn to regulate themselves by visualization & expectations.

Acupuncture is contraindicated for which of the following clients?

A. A 72-yr-old asthmatic

B. A 10-yr-old hemophiliac

C. A 23-yr-old with Crohn's disease

D. A 40-yr-old who is clinically depressed

B

This treatment is contraindicated in persons who have bleeding disorders, thrombocytopenia, or skin infections or who have a fear of needles.

A client undergoing chemotherapy treatment of lung cancer drinks ginger tea to help manage the resulting nausea. Which of the following medications should the nurse review for interactions?

A. Loop diuretics

B. Anticoagulants

C. Antidepressants

D. Antihypertensives

B

Ginger interacts with warfarin & other blood thinners, aspirin, & NSAIDs.

Which of the following statements made by a nurse shows the most appropriate understanding of skin Hunger?

A. For skin to be healthy, it must be fed.

B. Being touched is as important as being fed.

C. Touch provides emotional comfort to a client.

D. Skin requires adequate nutrients & hydration.

A

Touch is a primal need, as necessary as food, growth, or shelter.

Which of the following nursing statements best reflects the most therapeutic intervention regarding the client's need for human touch?

A. I always ask my clients if they need a hug.

B. It is important to use a light touch when giving a bath.

C. I offer my clients a backrub whenever giving them bedtime care.

D. When I meet a client for the first time, I always try to shake his/her hand.

C

Touch is a primal need, as necessary as food, growth, or shelter. This answer provides the most appropriate manner in which a nurse can provide touch from among the options.

The nurse is discussing the importance of human touch with the family of a comatose client. The daughter states I love my mother, but I find it so hard to touch her when she's like this. Which of the following nursing statements reflects the most therapeutic response?

A. Maybe it will get easier each time you touch her.

B. Touch is a human need, just like food, so please try.

C. Do you think it would be more comfortable to try washing her face & hands?

D. Your mother certainly wouldn't want you to do something that you find so difficult.

C

This is the only option that attempted to provide an acceptable solution for the family members problem.

A client diagnosed with osteoarthritis has been practicing tai chi regularly. Which of the following statements best shows the clients understanding of the value of this complementary therapy?

A. It is a great way to socialize & exercise at the same time.

B. I don't like to exercise, but Tai Chi doesn't seem like exercise.

C. The moves are so beautiful, & I feel so graceful when I practice them.

D. The gentle, slow movements exercise my joints without staining them.

D

Tai Chi incorporates breathing; gentle, flowing movements; & meditation to cleanse, strengthen, & circulate vital life energy & blood. Therapy stimulates the immune system & maintains external & internal balance.

A client is discussing his use of biofeedback. Which of the following statements shows the best understanding of success?

A. I have set aside one hour a day for practice.

B. My appointments are very important; I keep them all.

C. I find it empowering that I can do something to help myself.

D. Goals are important; setting them gives me something to work toward.

C

Clients who are compliant with appointments, practice times, goal setting & basically take responsibility for their treatment tend to be the most successful since it provides a sense of control over the situation.

The remaining options identify individual aspects of that control.

A client recently experienced the loss of their significant other & has symptoms of distress. In selecting a Complementary therapy, the nurse knows that the client may benefit the most from:

A. Relaxation therapy

B. Acupuncture

C. Feldenkrais method

D. Chiropractic medicine

A

Relaxation reduces symptoms of distress by giving them some control over their lives. An alternative method of producing analgesia.

In gathering information for the admission data base, the nurse discovers that a client who was admitted to the hospital for a total hip replacement has been taking ginkgo biloba to help with their memory. The nurse knows that this may cause an interaction with which of the medications.

A. Morphine sulfate

B. Warfarin

C. Docusate sodium

D. Docusate Sodium

B

Increases the risk of bleeding.

An elderly client is a nursing home describes to the nurse that they are LONEly. Based on this information, the nurse believes the patient may benefit from which of the following Complementary therapies?

A. Therapeutic Touch

B. Chinese medicine

C. Dance therapy

D. Guided imagery

A

Touch helps enhance self-esteem & sense of worth.

A client seeking care for stress tells the nurse that he is interested in seeking holistic care that incorporates body, mind, & spirit. The nurse knows that which of the following CAM therapies may be beneficial to him?

A. Chiropractic medicine

B. Chinese medicine

C. European phytomedicine

D. Allopathic medicine

B

Includes many modalities including acupuncture, herbs, touch, moxibustion, & qigong.

Physiotherapy by manipulation of spinal column. Traditional western medicine focusing on physical ailments.

Nurses who are interested in practicing CAM therapy can, with minimum preparation, incorporate which of the following into their nursing practice?

A. Biofeedback

B. Ayurveda

C. Therapeutic touch

D. Acupressure

C

Therapeutic touch is laying hands on a clients body.

Biofeedback requires advanced prep. & instruments. Ayurveda is traditional Hindu. Acupressure (Chinese) required preparation.

The nurse notes that the clients blood pressure is substantially higher than it was on their last annual checkup. On questioning, the nurse learns that the client has been taking herbal therapy. The nurse understands that which of the following herbs is a central nervous stimulant that can cause a rise in blood pressure.

A. Calamus

B. Ginseng

C. Feverfew

D. Ephedra

D

Ephedra is a central nervous stimulant.

The nurses most informed response to a client's question concerning what Allopathic medicine (Western medicine) is least effective at dealing with should include: (Select all that apply)

A. Managing stress

B. Disease prevention

C. Treating chronic illness

D. Meeting emotional needs

E. Curing bacterial infection

F. Treating acute emergencies

A, B, C, D

Allopathic medicine is effective in dealing with the management of bacterial infections & treating acute emergencies, while the remaining options represent conditions that are not as effectively managed.

When discussing Complementary medical therapies with a client, a nurse should include: (select all that apply)

A. Herbalism

B. Hypnotherapy

C. Guided imagery

D. Therapeutic touch

E. Respiratory therapy

F. Chiropractic therapy

A, B, C, D, F

Complementary therapies include guided imagery & breath work, relaxation; exercise, massage, reflexology; prayer, biofeedback; hypnotherapy; creative therapies, including art, music, or dance therapy; meditation; chiropractic therapy; osteopathy; and herbalism. Respiratory therapy is not considered complementary.

Which of the following objective assessment findings are likely to be seen in client's who have successfully implemented relaxation techniques? (Select all that apply)

A. Slower respirations

B. Lower blood sugar levels

C. Decreased heart rate

D. Lower blood pressure

E. Decreased deep reflexes

F. Warmer skin temperature

A, C, D, F

Decreased heart & respiratory rates, decreased blood pressure & oxygen consumption, & increased alpha brain activity & peripheral skin temperature characterize the relaxation response.