Question 1

Progressive relaxation techniques,biofeedback,meditation,and cognitive-behavioral approaches have a well-documented theoretical basis with supporting scientific evidence.What is the theoretical clinical justification for this relationship categorized as mind-body medicine?

Accepted Answer

Mind-body intervention is a growing scientific movement that has explored the mind's ability to affect the body.Some mind-body interventions (e.g.,behavioral-cognitive therapy),formerly categorized as complementary and alternative medicine (CAM)therapies,have been assimilated into conventional mainstream medicine.Other mind-body interventions still considered CAM include hypnosis,music,dance,art therapy,prayer,and mental healing.

Question 2

The National Center for Complementary and Alternative Medicine (NCCAM)has categorized the many integrative health practice modalities into five major domains.Biofield therapies are therapies that focus on fields believed to originate within the body.To which domain category does biofield therapy belong?

Accepted Answer

Energy therapies have been categorized into two groups: biofield therapies (those that focus on fields believed to originate within the body)and electromagnetic fields (those that originate from other sources).The existence of energy fields that originate within and around the body have not yet been definitively proven.However,many studies have examined the experiences of recipient or practitioner and the outcomes of this type of energy therapy.Examples of therapies with a biofield basis include acupuncture,reiki,qi gong,TT,and healing touch.Therapies that involve electromagnetic fields use unconventional pulsed fields,magnetic fields,alternating current fields,or direct current fields.These therapies have been clinically applied with patients who have arthritis,cancer,and pain.

Question 3

Therapeutic touch (TT)is a contemporary interpretation of several ancient healing modalities now used in perioperative practice.Why does the title therapeutic touch sound like a misnomer?

Accepted Answer

Therapeutic touch was developed in 1972 by Dolores Krieger and Dora Kunz.The manipulation is primarily 2 to 4 inches off the body.The centered practitioner assesses,directs,and modulates biofield energy to achieve the relaxation response for healing of the whole person.With TT,the practitioner manipulates the energy field by directing or modulating using the sense of touch much like the other four major senses of the body.All these senses can act from a distance without direct connection.The human energy field extends a few inches away from the body surface,and the practitioner senses fine energetic cues such as changes in pattern.

Question 4

A dietary supplement,as defined by the Dietary Supplement Health and Education Act (DSHEA),is a product that contains several ingredients that are intended to supplement the individual's diet.Which ingredient is considered an appropriate additive to classify a product as a dietary supplement?

Accepted Answer

Since 1994,when DSHEA was passed,the definition of dietary supplements has broadened.A product that contains a vitamin,mineral,herb,amino acid,or other botanic or dietary substance used to supplement the diet is considered a dietary supplement; this includes concentrates,metabolites,constituents,extracts,and combinations of listed ingredients.These supplements are no longer subject to premarket safety evaluations by the FDA.

Question 5

Anesthesia providers are concerned about the potential increased risk of instability intraoperatively resulting from inhibition of coagulation.Which herbal supplement,from the list below,would be implicated in a coagulation interaction?

Accepted Answer

Many plants contain anticoagulant components,including ginger,ginseng,feverfew,and others.However,it is unknown if the danger posed is clinically significant.

Question 6

What ancient Egyptian treatment promotes balance and wellness through nerve stimulation by pressure applications?

Accepted Answer

Reflexology is the ancient Egyptian method of applying pressure to sites (such as the foot,hands,and ears)that correspond with organs and nerves to cause a reflex arc of stimulation to the area in need.

Question 7

Many alternative medical therapies are culturally,ethnically,spiritually,or religiously derived and have a wide range of applications from health promotion to the treatment of illness.Key foundations of several therapies are a focus on universal connectedness (e.g.,that all living and nonliving things are joined together; health will be good if one's mind and body are in harmony and balance; disease arises when a person is out of harmony with the universe).Which of the therapies listed below prescribe to this belief system?

Accepted Answer

A significant aspect of Asian medicine is an emphasis on diagnosing and treating disturbances of qi (pronounced chee),or vital energy,and restoring its proper balance.Ayurveda is a traditional system from India that strives to restore the innate harmony of the individual while placing equal emphasis on body,mind,and spirit.Ayurvedic practitioners use many products and techniques to cleanse the body and restore balance.

Question 8

Select the alternative or complementary therapy that would be appropriate to integrate into the plan of care in the perioperative setting.

Accepted Answer

Guided imagery,or thinking in pictures,is the natural language of the unconscious mind and is used by the autonomic nervous system as a primary mode of communication.Guided imagery for surgical patients may be in the form of prescripted tapes that lead the patient through relaxation exercises and provide healing suggestions.In other instances,the perioperative nurse may assist the patient with guided imagery using a calming,monotone voice; a smooth speaking delivery; and the use of relaxing images,such as a place in nature.

Question 9

A certified clinical aromatherapy practitioner (CCAP)asks the pediatric patient for a favorite flavor from a short list of banana,strawberry,bubble gum,mint,or tutti-fruiti,and then proceeds to place a drop of the chosen flavor into the inhalation mask before anesthesia induction.The child inhales the favorite flavor while drifting off to sleep.This complementary therapy falls within the category of:

Accepted Answer

Aromatherapy in perioperative services involves the therapeutic use of fragrance (e.g.,aromatic plant extracts and essential oils)applied to the patient's body through inhalation or topical methods,or rarely ingestion.Long before Western medicine use of aromatherapy and herbs was part of physicians' practice and prescriptive use,it was taught in all the original Nightingale schools.Clinical aromatherapy is gaining acceptance with consent and participation of patients.It is practiced by CCAPs,knowledgeable about the specific properties of essential oils and how they interact with patients and the therapeutic environment.CCAPs use clinical-grade essential oils in a controlled way for specific,measurable outcomes.These may affect the patient on a psychologic,physiologic,or cellular level.

Question 10

Which therapeutic and healing therapy can the patient use throughout the perioperative experience (e.g.,preoperative,intraoperative,and postoperative phases)?

Accepted Answer

The therapeutic and healing properties of music have been recognized throughout history.Music has been shown to reduce stress and can block out unwanted noises around the patient during all perioperative phases,which makes the environment more enjoyable for the patient.

Question 11

Anesthesiologists recommend that patients stop taking any herbal supplements before surgery to prevent adverse herb-drug interactions.How long before surgery should the patient stop taking herbal supplements?

Accepted Answer

Because the use of botanic supplements may increase the risk of adverse herb-drug interactions,patients should be counseled to discontinue herbs preoperatively.Generally,anesthesiologists recommend that patients stop taking any herbal supplement at least 2 weeks preoperatively.

Question 12

Select the herbal supplement that may cause potential adverse cardiac effects such as palpitations and hypertension.

Accepted Answer

Ephedra has been associated with adverse cardiovascular effects,including hypertension,palpitations,tachycardia,stroke,and seizures.Hypertension and cardiac dysrhythmias are potential adverse events that may result from the sympathetic stimulation that occurs during intubation and surgery.

Question 13

In many cultures,a naturalistic or holistic approach often assumes that there are external factors (some good,some bad)that must be kept in balance if we are to remain well.Select the balance system that is common across several cultural belief systems.

Accepted Answer

The balance of "hot" and "cold" is a part of the belief system in many cultural groups,such as the Arab,Chinese,Filipino,and Hispanic cultures.To restore a disturbed balance (i.e.,to treat)requires the use of opposites (e.g.,a hot remedy for a cold problem).Different cultures may define hot and cold differently.It is not a matter of temperature,and the words used might vary; for example,the Chinese have named the forces yin (cold)and yang (hot).Western medicine cannot ignore the naturalistic view if many of its patients are to have appropriate treatment for illness as well as disease.

Question 14

Select the true statement that best differentiates biofields from electromagnetic fields.

Accepted Answer

Energy therapies have been categorized into two groups: biofield therapies (those that focus on fields believed to originate within the body)and electromagnetic fields (those that originate from other sources).The existence of energy fields that originate within and around the body has not yet been definitively proven.

Question 15

Which therapy is guided by the principle that dysfunction of one part of the body often affects secondarily the function of other discrete,possibly indirectly connected body parts?

Accepted Answer

Manual healing methods are based on the principle that dysfunction of a part of the body often affects secondarily the function of other discrete,possibly indirectly connected body parts.Theories have been developed for correction of these secondary dysfunctions by realigning body parts or manipulating soft tissues.

Question 16

Because of DSHEA,the FDA can restrict a marketed supplement only if its use has shown the product is unsafe.Because herbal products are so readily available and have such widespread media attention,many people think that they can safely self-medicate.Why should the public be aware and educated about dietary supplements and potential harmful effects?

Accepted Answer

There are no regulations establishing criteria for purity,manufacturing procedures,or identification of ingredients for these supplements.Therefore,the potential exists for high variability in the potency of different batches of the same botanical product.In addition,impurities and unknown substances may also be present in these products.

Question 17

Patients may be reluctant to communicate information about their use of herbal products,botanicals,or dietary supplements,because they may be unsure of the reaction of healthcare professionals to their use of alternative substances.Many herbal products have actions that could be dangerous during surgery.Select all the true statements about herbal supplements and perioperative drugs.

Accepted Answer

Some herbal supplements may accentuate the toxicity of anesthetics or interfere with drug metabolism or clearance.Some botanicals have significant sedative actions.Anesthesia providers are concerned about the potential for valerian and St.John's wort to prolong or potentiate the sedative effect of anesthetic agents.Valerian has been associated with CNS depression.St.John's wort has been found to inhibit the binding of naloxone.

Question 18

Herbal,orthomolecular,individual biologic therapies and special dietary treatments are encompassed in biologically based therapies.Which of the biologically based therapies listed below are classified as therapeutic nutrition?

Accepted Answer

Herbs are plants or parts of plants that contain and produce chemical substances that act on the body.Some diet therapies are believed to promote health and prevent or control health.Proponents of diet therapies include religious factions such as Seventh-day Adventist or Jewish Kosher.Veganism,vegetarianism,raw food diets,and diets promoted by Drs.Atkins,Pritikin,and Weil are other examples of therapeutic nutrition.Orthomolecular therapies use differing concentrations of chemicals or megadoses of vitamins aimed at treating disease.Many biologic therapies are available but not currently accepted by mainstream medicine,such as the use of cartilage products from cattle,sheep,or sharks for treatment of cancer and arthritis or the use of bee pollen to treat autoimmune and inflammatory diseases.

Question 19

Palpation during the nursing assessment is considered a "laying on of hands," and may be interpreted as therapeutic by the patient.Select the statement that best reflects the nurse-patient relationship during nursing assessment.

Accepted Answer

Palpation involves the use of your hands and fingers to gather information through the sense of touch.Certain parts of your hands and fingers are better than others for specific types of palpation.Touch is in many ways therapeutic,and palpation is the actuality of the "laying on of hands." It is the moment at which health practitioners begin their physical invasion of the patient's body.The oft-repeated advice that the approach to palpation be gentle and the practitioner's hands be warm is not only practical but also symbolic of respect for the patient and for the privilege the patient gives.

Question 20

Naturopathic medicine emphasizes health restoration as well as disease treatment based on the belief that disease is a manifestation of alterations in the body's natural healing processes.Which modality is considered within the scope of naturopathic medicine?

Accepted Answer

Naturopathic physicians use multiple modalities,including clinical nutrition and diet; acupuncture; herbal medicine; homeopathy; spinal and soft tissue manipulation; physical therapies involving ultrasound,light,and electric currents; therapeutic counseling; and pharmacology.

Quiz 30: Integrative Health Practices: Complementary and Alternative Therapies