Chapter 34 Complementary and Alternative Therapies in Maternity

Chapter 34 Complementary and Alternative Therapies in Maternity and Pediatric Nursing Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc.

Lesson 34. 1 Objectives 2. Define complementary and alternative medicine (CAM) therapy. 3. Identify the role of the nurse in CAM therapy. 4. Discuss the integration of CAM therapy in nursing practice. 5. Discuss the impact on nursing care of patients who use CAM therapy. 6. State three herbs that should be discontinued 2 weeks before surgery. 7. Describe the involvement of the federal government in CAM therapy. Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 2

Complementary and Alternative Therapies (p. 760) Complementary therapy Ø Nontraditional therapy that is used with traditional or conventional therapy Alternative therapy Ø Unconventional or nontraditional that replaces conventional or traditional therapy Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 3

Pediatric Use of CAM Therapies (p. 760) Increased use of CAM for variety of illnesses/conditions Many universities have federally funded research programs related to pediatrics and CAM Care needed when combining traditional medications with CAM supplements Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 4

Alternative Health Care (p. 761) Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 5

CAM Therapy (p. 760) Also known as Integrative therapy Ø Integrative healing Ø Holistic healing Ø Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 6

CAM Practitioners (p. 760) Holistic practitioners Naturopaths Nutritional consultants Food therapy Ø Vitamin and mineral supplements Ø Herbalist Practitioners of acupuncture and acupressure Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 7

Popular Cultural Folk Healers (p. 761) Mexican: Curanderos African American: Root doctor Asian and Chinese: Herbalist Puerto Rican: Espiritistas or santiguadoras Navajo: Singers Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 8

Accepted Theories (p. 761) Gate control theory of pain relief Imagery Journaling Therapeutic touch Humor Support groups Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 9

Nurse’s Role in CAM Therapy (p. 761) Cultural competence is a sensitivity and respect for practices and philosophies different from one’s own The need for nurses to understand CAM therapy, how it can be used, and how it may interact with or enhance traditional medical and nursing care important Nurses need to understand basic underlying philosophies and beliefs concerning CAM interventions Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 10

Nurse’s Role in CAM Therapy (cont. ) (p. 761) Is not to promote CAM therapy but to recognize and respect its use Use critical thinking skills to determine interactions with traditional therapies Work with the patient as a partner in the delivery of health care Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 11

Cautions in CAM Therapy (p. 762) Herbs can Interact with cardiac drugs Ø Affect glucose control in patients with diabetes Ø Lower the concentration of some synthetic drugs Ø Lower the blood level of some medications for HIV/AIDS Ø Polypharmacy should be avoided; the use of some drugs with herbal remedies can be dangerous Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 12

Herbs to Discontinue Two Weeks Before Surgery (p. 762) Echinacea Garlic Ginger Ginkgo biloba St. John’s wort Ginseng Kava kava Feverfew Ephedra (ma huang) Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 13

Federal Regulations (p. ) 1962: Kefauver-Harris Drug Amendment Act required FDA proof of safety and effectiveness for all drugs (not including herbal products) before placing them on the market 1992: NIH formed Office of Alternative Medicine to evaluate CAM therapies 1994: Dietary Supplement Health and Education Act defined dietary supplement and prohibited claim of medicinal value 1994: DSHEA required regulations for labeling and statement that there is no FDA approval Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 14

Lesson 34. 2 Objectives 8. State the use of meridians, dermatomes, and reflexology lines in CAM therapy. 9. State five types of CAM therapy in common use. Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 15

Overview of Common Alternative Health Care Practices Massage (p. 763) Thought to bolster immune response Rolfing—thought to improve muscle and bone function “Cao-gio” (coin rubbing) form of skin manipulation thought to help bring the body into healthy alignment Perineal massage in preparation for labor Effleurage—pain relief Gentle touch—for premature infants Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 16

Massage (cont. ) (p. 763) Massage and manipulative therapy are contraindicated in patients with Cancer Ø Osteoporosis Ø Localized infection Ø Cardiac and circulatory disorders Ø Because of the increased blood flow to the affected areas Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 17

Osteopathy (p. 763) Pressure point therapy Ø Certain areas of the body are connected to specific identified pressure points such as hands, feet, and ears Channels conduct vital energy through the body Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 18

Energy Healing (p. 763) Belief that electromagnetic flow emerges from therapist’s hand can funnel energy into the patient The body, the mind, the spirit, and the emotions are usually involved in this form of therapy Light therapy, another form of energy, is used to treat a jaundiced newborn Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 19

Reflexology (p. 763) Reflex points in the hands and feet thought to correspond to every organ or part of the body Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 20

Acupuncture and Acupressure (p. 764) Complex meridians that are pathways to specific organs or parts of the body It is at these points that positive or negative energy can be realigned “Chi” energy is thought to regulate proper body function Points to avoid during pregnancy are Bottom of foot Ø Inner lower leg Ø Base of thumb Ø Most areas over abdomen Ø Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 21

Homeopathy (p. 765) Uses plants, herbs, and earth minerals Belief that disease is an energy imbalance and that prescribed remedies assist the body to reestablish correct balance Taken sublingually Don’t combine with caffeine, alcohol, or traditional Western medicine Only one remedy is administered at a time Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 22

Ayurveda (p. 765) Ancient Hindu healing regimen Deals with biological rhythms of nature Includes music, herbs, massage, aromatherapy, and a tailored diet Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 23

Aromatherapy (p. 765) Involves the use of concentrated fluid or the essence of specific herbs that are combined with steams or baths to inhale or bathe skin NOTE: Concentrated pure oils can cause burns on the skin if used incorrectly Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 24

Nursing Tip (p. 765) Lavender, chamomile, and sandalwood essential oils are useful in aromatherapy for children with chronic pain Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 25

Hypnotherapy (p. 765) Patient enters a hypnotic state of induced sleep Under the guidance of a practitioner, specific and potentially long-lasting suggestions are given to the patient Some patients resist the trance state and are not candidates for hypnotherapy Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 26

Hydrotherapy (p. 765) Promotes relaxation Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 27

Guided Imagery (p. 765) Patient focuses on a specific image collection, which can result in the reduction of stress and increased performance Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 28

Biofeedback (p. 765) A type of relaxation therapy that enables the patient to recognize tension in the muscles via response on an electronic machine Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 29

Chiropractic Care (p. 765) Deals with the relationship between the spinal column and nervous system Involves nerve energy thought to be responsible for restoring and maintaining health Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 30

Lesson 34. 3 Objectives 10. State three herbal products contraindicated in pregnancy. 11. State three herbal products commonly used in pediatrics. 12. State popular herbs used during menopause. 13. Discuss the use of hyperbaric oxygen therapy in the care of carbon monoxide poisoning and necrotic ulcers. Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 31

Herbal Remedies (p. 765) Powerful nutritional agents Most are safe to ingest Herbal remedies consumed during pregnancy can reach the fetus Herbal capsules are about 4 times stronger than herbal teas Herbal extracts are about 4 to 8 times stronger than capsules Most extracts should not be taken for longer than 6 consecutive days Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 32

Common Herbs Contraindicated in Pregnancy and Lactation (p. 766) Aloe vera Garlic Ginkgo biloba St. John’s wort Angelica (dong quai) Chamomile Feverfew Flax (flaxseed) Ginseng Kava kava Ma huang (ephedra) Nettle Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 33

Herbs and Pediatrics (p. 767) Blue-green algae Chamomile Ephedra Echinacea Evening primrose oil Fennel seed oil Feverfew Fish oil Ginger Ginkgo biloba Ginseng Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 34

Herbs that Promote Menstruation (p. 767) The following herbs promote menstruation and may cause miscarriage if used during pregnancy: Cascara Ø Cohosh Ø Goldenseal Ø Juniper Ø Marjoram Ø Motherwort Ø Mugwort Pennyroyal Sage Senna Wormwood Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 35

Herbs and Menopause (p. 769) Black cohosh Sage Dong quai Chasteberry Motherwort Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 36

Hyperbaric Oxygen Therapy (p. 769) Uses an airtight enclosure to provide compressed air or oxygen under increased pressure Contraindicated in pregnancy Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 37

Sauna/Heat Therapy (p. 769) Thought to help eliminate body waste Patients should monitor their pulse during this form of treatment This type of therapy is contraindicated in pregnancy Elsevier items and derived items © 2015, 2011, 2007, 2006 by Saunders, an imprint of Elsevier Inc. 38