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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.
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.
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.
Definition of CAM Therapies
Complementary therapy
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Nontraditional therapy that is used with traditional or conventional therapy
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Alternative therapy
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Unconventional or nontraditional that replaces conventional or traditional therapy
Alternative Health Care
CAM Therapy
Also known as
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Integrative therapies
Integrative healing
Holistic healing
CAM Practitioners
Holistic practitioners
Naturopaths
Nutritional consultants
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Food therapy
Vitamin and mineral supplements
Herbalist
Practitioners of acupuncture and acupressure
Popular Cultural Folk Healers
Mexican: Curanderos
African American: Root doctor
Asian and Chinese: Herbalist
Puerto Rican: Espiritistas or santiguadoras
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Navajo: Singers
Accepted Theories
Gate control theory of pain relief
Imagery
Journaling
Therapeutic touch
Humor
Support groups
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
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
Cautions in CAM Therapy
Herbs can
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Interact with cardiac drugs
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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
Herbs to Discontinue Two Weeks
Before Surgery
Echinacea
Garlic
Ginger
Gingko biloba
St. John’s wort
Ginseng
Kava kava
Feverfew
Ephedra (ma huang)
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
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
Massage (cont.)
Massage and manipulative therapy are contraindicated in patients with
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Cancer
Osteoporosis
Localized infection
Cardiac and circulatory disorders
Because of the increased blood flow to the affected areas
Osteopathy
Pressure point therapy
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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
Energy Healing
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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
Reflexology
Reflex points in the hands and feet thought to correspond to every organ or part of the
body
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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Bottom of foot
Inner lower leg
Base of thumb
Most areas over abdomen
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
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
Nursing Tip
Lavender, chamomile, and sandalwood essential oils are useful in aromatherapy for
children with chronic pain
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
Hydrotherapy
Promotes relaxation
Guided Imagery
Patient focuses on a specific image which can result in the reduction of stress and
increased performance
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
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
Common Herbs Contraindicated in Pregnancy and Lactation
Aloe vera
Garlic
Ginkgo biloba
St. John’s wort
Angelica (dong quai)
Chamomile
Feverfew
Flax (flaxseed)
Ginseng
Kava kava
Ma huang (ephedra)
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Nettle
Herbs Commonly Used in Pediatrics
Blue-green algae
Chamomile
Ephedra
Echinacea
Evening primrose oil
Fennel seed oil
Feverfew
Fish oil
Ginger
Ginkgo biloba
Ginseng
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
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Pennyroyal
Sage
Senna
Wormwood
Popular Herbs Used in Menopause
Black cohosh
Sage
Dong quai
Chasteberry
Motherwort
Hyperbaric Oxygen Therapy
Uses an airtight enclosure to provide compressed air or oxygen under increased pressure
Contraindicated in pregnancy
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
Question for Review
What are some CAM therapies that are currently used regularly in the labor unit?
Review
Objectives
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Key Terms
Key Points
Online Resources
Critical Thinking Questions
Review Questions