Question 1

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 2

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).

Question 3

Herbal supplements may have a role in the perioperative setting and are an important consideration for nurses.A mistaken assumption is that botanical dietary supplements are safer than prescribed or over-the-counter drugs.What assumption should the nurse make,during the nursing assessment,when the patient describes the use of dietary supplements and herbal products?

Accepted Answer

Botanicals may initiate a pharmacologic response within the body and therefore should be considered as medications from a medical or nursing perspective.Many herbal products have actions that could be dangerous during surgery.Some herbal supplements may accentuate the toxicity of anesthetics or interfere with drug metabolism or clearance.

Question 4

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 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 5

Which of the manipulative therapies uses many different hands-on techniques aimed at helping the body heal itself through the manipulation of the soft body tissues?

Accepted Answer

Methods that are based on the movement or manipulation of the body include chiropractic,osteopathy,and massage.Massage therapy is one of the oldest methods known in the practice of healthcare.

Question 6

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

The diets promoted by Drs.Atkins,Pritikin,and Weil,as well as veganism,vegetarianism,and raw food diets,are examples of therapeutic nutrition.Many biologic therapies are available that are 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 7

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 central nervous system (CNS)depression.St.John's wort has been found to inhibit the binding of naloxone.

Question 8

As a result of the Dietary Supplement Health and Education Act (DSHEA),the Food and Drug Administration (FDA)can restrict a marketed supplement only if its use has shown the product is unsafe.New supplements no longer subject to premarket safety evaluations by the FDA.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 9

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

Accepted Answer

Music is recognized as a way to decrease the physiologic and behavioral anxiety found in most individuals awaiting surgical procedures,and has been validated through many research and evidence-based studies and reviews.Best of all,music therapy can be used preoperatively,intraoperatively,and postoperatively.

Question 10

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

Touch is in many ways therapeutic,and palpation is the actuality of the "laying on of hands." It is the moment at which we begin our physical invasion of the patient's body.Our much-repeated advice that "your approach is gentle and your hands are warm" is not only practical but also symbolic of your respect for the patient and for the privilege the patient gives you.

Question 11

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

Accepted Answer

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.

Question 12

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 are able to 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 13

Trina Gasterson,a 7-year-old girl recovering from a successful kidney transplant,is visited by her perioperative nurse on her day of discharge.While they conversed,Trina's mother opened a bottle of herbal supplement tablets from a local nutrition and dietary supplement store,whose label the nurse recognized.The mother proceeded to offer the supplement to Trina,but the nurse intervened and questioned the mother about the supplement.After reading the label,the nurse explained that the tablets could have an adverse interaction with Trina's immunosuppressive drugs that she must take to prevent transplant rejection.What herbal supplement was in the bottle?

Accepted Answer

Astragalus,licorice,and echinacea are similar in action to corticosteroids and cyclosporine and can inhibit immunosuppressive effects.

Question 14

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 through the use of a calming,monotone voice;a smooth speaking delivery;and the use of relaxing images,such as a place in nature.

Question 15

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.What modalities from the list below are 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.

Question 16

What 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 (e.g.,massage,chiropractic,and osteopathic medicine)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 developed for correction of these secondary dysfunctions by realigning body parts or manipulating soft tissues.

Question 17

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 18

Postoperative nausea and vomiting (PONV)are significant problems for many patients administered general anesthetics.This complication not only is distressing for the patient but also,if uncontrolled,can result in additional complications such as wound dehiscence,fatigue,dehydration,and electrolyte imbalances.What herbal substance was studied by researchers in Thailand and found to be an effective option in the prevention of PONV?

Accepted Answer

Researchers concluded that ginger is an effective therapeutic option in the prevention of PONV,but the exact role of ginger as an antiemetic warrants additional study.Ginger has long been used in China as a treatment for nausea and vomiting.

Question 19

The anesthesia provider 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.Potential uses for perioperative services include reducing anxiety for patients and their families in the waiting area and ameliorating nausea and vomiting during the immediate postoperative phase.

Question 20

Select the herbal supplement that may cause potential adverse cardiac effects such as palpations 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.

Quiz 29: Integrated Health Practices:Complementary and Alternative Therapies