Chapter 34
Complementary and Alternative
Therapies in Maternity and Pediatric
Nursing
Objectives
• Define complementary and alternative
medicine (CAM) therapy.
• Identify the role of the nurse in CAM therapy.
• Describe the involvement of the federal
government in CAM therapy.
• Discuss the integration of CAM therapy in
nursing practice.
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Objectives (cont.)
• Discuss the impact on nursing care of
patients who use CAM therapy.
• State five types of CAM therapy in common
use.
• State three herbal products contraindicated in
pregnancy.
• State three herbal products commonly used
in pediatrics.
• State popular herbs used during menopause.
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Objectives (cont.)
• Discuss the use of hyperbaric oxygen therapy
in the care of carbon monoxide poisoning and
necrotic ulcer.
• State three herbs that should be discontinued
2 weeks before surgery.
• State the use of meridians, dermatomes, and
reflexology lines in CAM therapy.
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Definition of CAM Therapies
• Complementary therapy
– Nontraditional therapy that is used with
traditional or conventional therapy
• Alternative therapy
– Unconventional or nontraditional that replaces
conventional or traditional therapy
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Alternative Health Care
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CAM Therapy
• Also known as
– Integrative therapies
– Integrative healing
– Holistic healing
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CAM Practitioners
• Holistic practitioners
• Naturopaths
• Nutritional consultants
– Food therapy
– Vitamin and mineral supplements
• Herbalist
• Practitioners of acupuncture and acupressure
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Popular Cultural Folk Healers
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•
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•
•
Mexican: Curanderos
African American: Root doctor
Asian and Chinese: Herbalist
Puerto Rican: Espiritistas or santiguadoras
Navajo: Singers
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Accepted Theories
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Gate control theory of pain relief
Imagery
Journaling
Therapeutic touch
Humor
Support groups
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Nurse’s Role in CAM Therapy
• 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 are important
• Nurses need to understand basic underlying
philosophies and beliefs concerning CAM
interventions
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Nurse’s Role in CAM Therapy
(cont.)
• 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
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Cautions in CAM Therapy
• Herbs can
– Interact with cardiac drugs
– Affect glucose control in patients with diabetes
– Lower the concentration of some synthetic
drugs
– Lower the blood level of some medications for
HIV/AIDS
• Polypharmacy should be avoided; the use of
some drugs with herbal remedies can be
dangerous
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Herbs to Discontinue Two Weeks
Before Surgery
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•
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•
•
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•
•
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Echinacea
Garlic
Ginger
Gingko biloba
St. John’s wort
Ginseng
Kava kava
Feverfew
Ephedra (ma huang)
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Federal Regulations
• 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
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Overview of Common Alternative
Health Care Practices
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Massage
• 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
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Massage (cont.)
• Massage and manipulative therapy are
contraindicated in patients with
–
–
–
–
Cancer
Osteoporosis
Localized infection
Cardiac and circulatory disorders
• Because of the increased blood flow to the
affected areas
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Osteopathy
• Pressure point therapy
– 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
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Energy Healing
• Belief that electromagnetic flow emerges
from the therapist’s hand and 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
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Reflexology
• Reflex points in the
hands and feet
thought to
correspond to
every organ or part
of the body
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Acupuncture and Acupressure
• 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
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–
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Bottom of foot
Inner lower leg
Base of thumb
Most areas over abdomen
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Homeopathy
• 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
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Ayurveda
• Ancient Hindu healing regimen
• Deals with biological rhythms of nature
• Includes music, herbs, massage,
aromatherapy, and a tailored diet
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Aromatherapy
• Involves the use of concentrated fluid or the
essence of specific herbs that are combined
with steams or baths to inhale or bathe the
skin
• NOTE: Concentrated pure oils can cause
burns on the skin if used incorrectly
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Nursing Tip
• Lavender, chamomile, and sandalwood
essential oils are useful in aromatherapy for
children with chronic pain
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Hypnotherapy
• 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
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Hydrotherapy
• Promotes relaxation
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Guided Imagery
• Patient focuses on a specific image which
can result in the reduction of stress and
increased performance
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Biofeedback
• A type of relaxation therapy that enables the
patient to recognize tension in the muscles
via response on an electronic machine
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Chiropractic Care
• Deals with the relationship between the
spinal column and nervous system
• Involves nerve energy thought to be
responsible for restoring and maintaining
health
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Herbal Remedies
• 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
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Common Herbs Contraindicated in
Pregnancy and Lactation
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Aloe vera
Garlic
Ginkgo biloba
St. John’s wort
Angelica (dong quai)
Chamomile
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•
•
Feverfew
Flax (flaxseed)
Ginseng
Kava kava
Ma huang (ephedra)
Nettle
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Herbs Commonly Used in
Pediatrics
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Blue-green algae
Chamomile
Ephedra
Echinacea
Evening primrose oil
Fennel seed oil
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•
•
•
Feverfew
Fish oil
Ginger
Ginkgo biloba
Ginseng
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Herbs that Promote Menstruation
• The following herbs promote menstruation and
may cause miscarriage if used during pregnancy:
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Cascara
Cohosh
Goldenseal
Juniper
Marjoram
Motherwort
Mugwort
Pennyroyal
Sage
Senna
Wormwood
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Popular Herbs Used in Menopause
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Black cohosh
Sage
Dong quai
Chasteberry
Motherwort
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Hyperbaric Oxygen Therapy
• Uses an airtight enclosure to provide
compressed air or oxygen under increased
pressure
• Contraindicated in pregnancy
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Sauna/Heat Therapy
• Thought to help eliminate body waste
• Patients should monitor their pulse during this
form of treatment
• This type of therapy is contraindicated in
pregnancy
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Question for Review
• What are some CAM therapies that are
currently used regularly in the labor unit?
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Review
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Objectives
Key Terms
Key Points
Online Resources
Critical Thinking Questions
Review Questions
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