Chapter 5 Complimentary & Alternative Therapies

Ginkgo biloba increase blood flow to the brain

enhancing brain function

Herbs may contain multiple compounds that are not on the label

all the ingredients may not be known.

If a patient receives an anticoagulant medication due to a previous history of blood clots, the nurse should reinforce that the patient should not take

garlic

Dietary supplements have not been tested for

safety or efficacy

Herbal medications could be helpful

not curative.

This stuff has a placebo effect.

Platelet inhibitors and blood thinners are in the same class when it comes to the application of herbs. So if someone is on an antiplatelet or a full-on Coumadin, they should avoid

garlic and Cinnamon, Ginkgo biloba

There are a few herbs that promote relaxation and sleep, such as

kava kava and peppermint.

Valerian has been used for over as mild tranquilizer.

1,000 years

Herbs have the United States Pharmacopeia (USP) pharmaco Peenya seal of approval, but do not make any claims about the product's therapeutic efficacy.

Herbs have the United States Pharmacopeia (USP) pharmaco Peenya seal of approval, but do not make any claims about the product's therapeutic efficacy.

Hawthorn used for heart disease, digestive issues, kidney disease, side effects or headaches dizziness, nausea.

can also interact with blood pressure medications

Hawthorn used for heart disease, digestive issues, kidney disease, side effects or headaches dizziness, nausea.

can also interact with blood pressure medications

Green tea is full of caffeine and actually cause people to have high blood pressure.

Green tea is full of caffeine and actually cause people to have high blood pressure.

Licorice is used for bronchitis , sore throat , most commonly used for sore throat stomach ulcers. high doses can lead to salt and water retention, elevate blood pressure. and cause preterm labor.

Licorice is used for bronchitis , sore throat , most commonly used for sore throat stomach ulcers. high doses can lead to salt and water retention, elevate blood pressure. and cause preterm labor.

Milk thistle is used commonly with gallbladder liver

widely to treat cirrhosis, chronic hepatitis, gallbladder issues

Milk thistle is used commonly with gallbladder liver

widely to treat cirrhosis, chronic hepatitis, gallbladder issues

hypercholesterolemia or elevated lipids to 200-230, May be encouraged to take milk thistle and Garlic if over 230 do not encouraged.

hypercholesterolemia or elevated lipids to 200-230, May be encouraged to take milk thistle and Garlic if over 230 do not encouraged.

Aloe helps your skin, sunburn, psoriasis, also helps GI tract people that take it orally

Aloe helps your skin, sunburn, psoriasis, also helps GI tract people that take it orally

Multiple Sclerosis is an autoimmune disease, You don't want to take Echinacea with Multiple Sclerosis.

Multiple Sclerosis is an autoimmune disease, You don't want to take Echinacea with Multiple Sclerosis.

Ginseng

uses are well being stamina, immune system treats erectile dysfunction, hepatitis C menopausal symptoms.

Ginseng It can lower glucose and high blood pressure

Ginseng It can lower glucose and high blood pressure

Ginseng side effects headache, GI distress, high blood pressure. Low blood glucose, breast tenderness and menstrual irregularities.

Ginseng side effects headache, GI distress, high blood pressure. Low blood glucose, breast tenderness and menstrual irregularities.

Herbs that help with GI disorders, include Peppermint, Ginger, Cinnamon and chamomile

Herbs that help with GI disorders, include Peppermint, Ginger, Cinnamon and chamomile

No comprehensive regulations of herbal supplements regarding safety and efficacy

No comprehensive regulations of herbal supplements regarding safety and efficacy

Manufacturers are supposed to list the scientific name of the product, the parts of the used in preparation of the product.

plant

green tea at very high quantities can cause birth defects.

green tea at very high quantities can cause birth defects.

1. A family member expresses concern that a patient is taking several herbal remedies and

worries that they may be unsafe. The nurse will respond by saying that herbal products:

a. are classified as medications by the Dietary Supplement Health and Education Act of 1994.

b. are regulated by the government and are determined to be safe.

c. aren't usually effective but are generally harmless.

d. should be discussed with the patient's provider in conjunction with other medications.

d. should be discussed with the patient's provider in conjunction with other medications.

Herbs are sometimes useful but can also be useless or dangerous. There are no agencies that regulate safety and efficacy. Patients should always tell providers if they are taking any herbal remedies since there are known drug-herbal interactions and side effects.

2. A pregnant woman tells the nurse that she is taking ginger to reduce morning sickness. What

will the nurse tell this patient?

a. "Ginger can cause fetal birth defects."

b. "Ginger is not safe during pregnancy."

c. "Ginger can cause abortion in low doses."

d. "Ginger may be taken for the short-term treatment of nausea associated with pregnancy."

d. "Ginger may be taken for the short-term treatment of nausea associated with pregnancy."

Ginger may be taken during pregnancy for morning sickness, but only on a short-term, low-dose basis.

3. A patient asks the nurse about an herbal supplement and reports that it has a United States

Pharmacopeia (USP) seal of approval. The nurse explains that this indicates:

a. identity, potency, purity, and labeling accuracy.

b. premarket testing for safety and efficacy.

c. structure and function claims may be made.

d. the supplement's ability to prevent and treat disease.

a. identity, potency, purity, and labeling accuracy.

The USP "seal of approval" indicates accuracy of the products identity, potency, purity, and labeling. It does not indicate premarket research on safety and accuracy, does not allow manufacturers to make claims about the function of the products, and does not indicate the substance's ability to prevent and treat disease.

4. A woman reports using ginseng to treat menopausal symptoms. Which response by the nurse

is correct?

a. "Ginseng will inhibit your immune system."

b. "Ginseng can increase risk of hypoglycemia if taken with diabetes medications."

c. "Side effects of ginseng are common."

d. "You may experience a decrease in blood pressure while taking ginseng."

b. "Ginseng can increase risk of hypoglycemia if taken with diabetes medications."

People with diabetes taking ginseng should consult with their provider if used in conjunction with other herbs or drugs, because hypoglycemia may result. It may boost the immune system. Side effects are rare except with long-term use or in large doses. Ginseng can increase blood pressure.

5. A woman who is experiencing symptoms of heart failure asks the nurse about using hawthorn.

Which response by the nurse is correct?

a. "Hawthorn may be used long term in conjunction with nitrates."

b. "Hawthorn may contribute to hypertension."

c. "Hawthorn may interact with antihypertensive drugs."

d. "Hawthorn treats heart failure by lowering potassium levels."

c. "Hawthorn may interact with antihypertensive drugs."

Hawthorn may increase the action of antihypertensive medications.

Hawthorn may decrease blood pressure.

6. A patient who has HIV asks the nurse about taking Echinacea to improve immune function.

What will the nurse tell this patient?

a. "The root extract is proven to be effective in treating upper respiratory and urinary

tract infections."

b. "Research regarding the benefits of Echinacea is inconclusive."

c. "Use it as needed when antibiotics fail to treat your infections."

d. "You may use it safely up to 8 weeks at a time as a preventive medication."

b. "Research regarding the benefits of Echinacea is inconclusive."

Research regarding the benefits of Echinacea as treatment for cold and flu symptoms is

inconclusive.

The use of Echinacea to stimulate the immune system of patients with HIV is

being investigated, but its use is currently not recommended.

7. The nurse is counseling a female patient who reports taking ginger to treat postoperative

nausea. Which statement by the patient indicates understanding of the teaching?

a. "I should experience immediate effects with this herb."

b. "Potential side effects include gas, bloating, and heartburn."

c. "I should take ginger with nonsteroidal anti-inflammatory drugs (NSAIDs) to enhance its effects."

d. "If I develop gastrointestinal (GI) upset, I should stop taking ginger immediately."

b. "Potential side effects include gas, bloating, and heartburn."

Patients may not experience immediate beneficial effects. Patients should not take ginger with NSAIDs without consulting the provider.

GI upset (gas, bloating, heartburn) are common side effects of the herb, but do not require immediate discontinuation.

8. The nurse is providing preoperative education to a patient who will have surgery in several

weeks. The patient denies taking anticoagulant medications but reports using herbal

supplements. Which herb would cause the nurse to be concerned about increased bleeding risk

when used with blood thinners?

a. Echinacea

b. Ginkgo biloba

c. Kava

d. Sage

b. Ginkgo biloba

Ginkgo can prolong bleeding time and therefore should be discontinued 2 weeks prior to surgery.

9. The nurse provides counseling to a patient who reports taking licorice root to treat a stomach

ulcer. Which statement by the patient indicates understanding of the teaching?

a. "I may take licorice root with prednisone."

b. "I may develop hypotension while taking licorice root."

c. "I should avoid licorice root when pregnant."

d. "I should try licorice instead of coming back to see the provider."

c. "I should avoid licorice root when pregnant."

In large amounts, licorice root has been associated with preterm labor and should be avoided in women who are pregnant.

Licorice root when taken with corticosteroids can lead to life-threatening hypokalemia.

In large amounts, it can elevate blood pressure.

10. Which herb listed below is used to treat cirrhosis and chronic hepatitis?

a. Ginkgo biloba

b. Kava

c. Milk thistle

d. Sage

c. Milk thistle

Milk thistle has been used widely to treat cirrhosis, chronic hepatitis, and gallbladder

disorders.

11. A patient reports taking St. John's wort to treat symptoms of depression and asks the nurse

how to use this product safely and effectively. Which response by the nurse is correct?

a. "Apply sunscreen while taking St. John's wort."

b. "It is absolutely safe to take St. John's wort with prescription antidepressants."

c. "St. John's wort only interacts with antidepressant medications."

d. "You should take St. John's wort as needed when symptoms occur."

a. "Apply sunscreen while taking St. John's wort."

St. John's wort can cause photosensitivity, so patients should be counseled to use sunscreen. Combined use with prescription antidepressants has been associated with a potential increase in the risk of suicidal ideation, so use should be discussed with the healthcare provider. St. John's wort interacts with a variety of other medications. Full effects do not occur for 4 to 8 weeks, so it cannot be taken as needed.

12. A patient asks the nurse about the safety of herbal products in general. Which response by the

nurse is correct?

a. "Consumers should research products and their manufacturers before taking."

b. "Manufacturers are required to list interactions of herbs with drugs and food."

c. "Products manufactured for drug and grocery store chains are safe."

d. "Toxicological analysis is required of all commercial herbal products."

a. "Consumers should research products and their manufacturers before taking."

There are no comprehensive regulations of herbal supplements regarding safety and efficacy, so consumers should research herbs and product manufacturers. Companies manufacturing for drug and grocery stores are suspect and do not always list all ingredients on their labels.

13. Which information can consumers expect to be included in labeling of herbal products?

a. Actions and uses

b. Interactions and precautions

c. Scientific name of the product

d. Safety and efficacy study results

c. Scientific name of the product

Manufacturers should list the scientific name of the product and the parts of the plant used in

preparation. They are not required to list actions, uses, interactions, precautions, and any

results of safety or efficacy studies.

1. Which herbal remedies are often used for GI disorders? (Select all that apply.)

a. Chamomile

b. Cinnamon

c. Echinacea

d. Ginger

e. Ginkgo Biloba

f. Peppermint

a. Chamomile

b. Cinnamon

d. Ginger

f. Peppermint

Chamomile, cinnamon, ginger, and peppermint are often used to treat GI disorders.

A nurse is caring for a client who uses herbal products to treat his arthritis. The nurse should recognize that herbal products are classified as which type of complementary and alternative medicine (CAM)?

A. Mindbody therapies

B. Biologically based therapies

C. Manipulative and bodybased therapies

D. Energy therapies

B. Biologically based therapies

A nurse is educating a client who wants to use St. John's wort as an alternative treatment for depression. The nurse should inform the client that St. John's wort may interact with which of the following conventional drugs?

A. Oral contraceptives

B. Anticoagulants

C. Antiretrovirals

D. All of the above

D. All of the above

A nurse is educating a client who wants to use garlic as a CAM product to lower his cholesterol level. The nurse should inform the client that garlic may interact with which of the following conventional drugs?

A. Aspirin, an antiplatelet agent for cardiovascular prevention

B. Simvastatin, a statin for hyperlipidemia

C. Metoprolol, a beta blocker for hypertension

D. All of the above

A. Aspirin, an antiplatelet agent for cardiovascular prevention

A nurse is reviewing the laboratory results of a client who uses licorice as a CAM product to treat his cough and sore throat. The nurse should expect that licorice may have which of the following effects on his laboratory results?

A. Decrease in serum potassium level and increase in serum sodium level

B. Increase in serum potassium level and decrease in serum sodium level

C. Decrease in serum calcium level and increase in serum magnesium level

D. Increase in serum calcium level and decrease in serum magnesium level

Decrease in serum potassium level and increase in serum sodium level