FUNDAMENTALS EXAM #4 STUDY NOTES
TOPIC TLLL CHAPTER ATI CHAPTER
Complementary and Alternative Therapies 27 42
Self Concept 40 34
Fluid, Electrolyte, and Acid- Base Balance 39 49,54,57,58
Stress and Adaptation 41 33
Sensory Functioning 43 45
Sexuality 44 24
CHAPTER 27: COMPLEMENTARY AND ALTERNATIVE THERAPIES
Why Nurses Need to Know CAT
, ● Many pts use these therapies as outpatients and want to continue their use as inpatients
Complementary/ Alternative Medicine
● Mind, body, and spirit are integrated and contribute to health and illness
● Health is balance of body systems: mental, social, spiritual, and physical
● Illness is manifestation of imbalance or disharmony
● Symptoms are sign or reflection of a deeper instability within person; restoring physical
and mental harmony will alleviate symptoms
● Emphasis is on health, healing is done by pt, care is individualized
CAM Terminology
● Allopathy: traditional medical care
● Holism: connection and interactions between parts of the whole
● Integrative care: allopathic + complementary/ alternative modalities
Allopathic Medicine (Biomedicine)
● Illness occurs in either mind or body, which are separate entities
● Health is absence of dx
● Main causes of illnesses are pathogens
● Curing seeks to destroy the invading organism or repair affected part
● Emphasis is on dx and high technology; spearheaded remarkable advances in
biotechnology, surgical interventions, pharm approaches, dx tools
● Dominant for about 100 yrs
Holism
● Theory and philosophy that focuses on connections and interactions between parts of
whole
● All living organisms are continuously connecting and interacting w/ environment
● Parts of organism are always interacting and changing
● Continual interaction and change means body is not the sum of its parts, but it is unified,
dynamic whole
● Goal of holistic nursing is healing the whole person. American Holistic Nurse Association
promotes education of nurses, other health care professionals, and public in all aspects
of holistic caring and healing.
Holistic Nursing: 3 Questions to Ask Self
● What do you know about the meaning of healing?
● What do you do each day to facilitate healing in yourself?
● How can you be an instrument of healing and a nurse healer?
Integrative care: uses combo of allopathic medicine and CAT. Many people use CAT for stress
management/ reduction (e.g. relaxation w/ focused breathing, meditation, imagery, biofeedback,
massage)
Use of CAT in the US:
● 38% adults in 2007 and 12% children used CAT in last 12 months.
● More prevalent among women, adults age 30-69, adults w/ higher education, not poor,
, West living, former smokers, and hospitalized in last year, private health insurance.
● Mostly American Indian/ Alaska Native people used CAT. Only ⅓ respondents and ½
CAM users have discussed CAM w/ healthcare providers.
● Most frequently used CAT were nonvitamin, nonmineral, natural products; deep
breathing exercises; meditation; chiropractic or osteopathic manipulation; massage;
yoga
● Most frequently used CAT for children: non vitamin mineral, natural products,
chiropractic or osteopathic manipulation, deep breathing exercises, yoga, homeopathic
treatment
NCCAM’s 10 Guiding Principles for CAT
Wholeness orientation in health care delivery Evidence of safety and efficacy
Healing capacity of person Respect for individuality
Right to choose treatment Emphasis on health promotion and self-care
Partnerships as essential to integrated healthcare Education as a fundamental healthcare service
Dissemination of comprehensive timely info Integral public involvement
Cat Categories (Domains)
Whole medical systems Allopathic model; origin of dx, ways to promote health, treatment types
Mind-body therapies relaxation, meditation, guided imagery, prayer, aromatherapy. 53% uses it
Energy medicine therapeutic touch, healing touch, sound healing
~ 4 scientific premises of therapeutic touch: human being is open energy
system, human being is bilaterally symmetrical, illness is imbalance in an
individual’s energy field, human beings have natural ability to transform and
transcend their conditions of living
Biologically based practices botanicals & nutritional supplements. Nutritional therapy.
Manipulative and body-based Works w/ structures and systems of body, including bones, joints, soft tissues,
practices circulatory and lymphatic systems
Types of CAT Systems and Therapies
Ayurveda ~ originated in Vedic civilization of India. Balance among people, environment, and larger cosmos integral to
health.
~ Central is pt’s basic constitution- dosha. Vata (changeable), pitta (intense), kapha (relaxed).
~ Uses nutrition, exercise, herbs, breathing, meditation, massage, aromatherapy, purification.
Yoga ~ Ashtanga: focuses on synchronizing breath w/ fast-paced series of postures
~ Bikram: done in 105 degree studio w/ 26 set postures
, ~ Iyengar: focuses on proper alignment and holds poses for a relatively longer time
~ Kripaula: “gentle yoga”, focuses on relaxation and coming into balance
Traditional ~ Yin: cool, moist dark
~ Yang: hot, dry, light
Chinese
~ Yin-yang theory: concept of 2 opposing, yet complementary, forces that shape world and life
medicine ~ Eight principles: cold/ heat, interior/ exterior, excess/ deficiency, yin/ yang. Analyze symptoms and categorize
conditions
~ Five elements: fire, earth, metal, water, and wood correspond to organs and tissues and explain how the
body works
Acupuncture ~ Qi: vital energy or life force that circulates in the body through meridian (systems of pathway)
~ Qi flows vertically through body through 12 meridians
~ Places thin needles at particular acupoints to change flow of energy and restore the balance of yin and yang
~ Reduces pain, promotes adherence to substance abuse programs, minimizes nausea & vomiting
Qi gong ~ System of posture. Exercise is gentle & dynamic, includes breathing techniques. Visualization regulates.
Shamanism ~ Most widely practiced medical system
~ Illness thought to originate in spirit world
~ Shaman or medicine man/ woman accessed spirit world to obtain info on the proper treatment
~ May consist of retrieving lost soul energy, restoring the individual to right relationship w/ spirit world and
treating symptoms
~ Healing techniques involves native plants and herbs, animals, rituals, ceremonies, and purification techniques
Homeopathy ~ “Like cures like”: dx can be cured by substance that produces similar symptoms in health people
~ “Law of minimum dose”: lower dose of med then greater its effectiveness. Many homeopathic remedies are
so diluted that no molecules of original substance remain
Naturopathy ~ First, do no harm. Physician is teacher. Treat whole person. Prevention. Healing power of nature. Treat cause.
Chiropractic ~ Spinal adjustment, heat and ice, relaxation techniques, rehab and exercise, counseling about diet, weight loss,
lifestyle, dietary supplements
CHAPTER 40: SELF- CONCEPT
Self esteem: need to feel good about oneself and to believe that others hold one in high regard
Self- actualization: need to reach one’s potential through full development of one’s unique
capability
Identity diffusion: failure to integrate various childhood identifications into a harmonious adult
psychosocial identity, which can lead to disruptions in relationships and problems of intimacy
Depersonalization: subjective experience of partial or total disruption of one’s ego and
disintegration of one’s self-concept
Three DImensions of Self- Concept
(1) Self knowledge: who am i? Subjective and sensitive to change. Basic facts, position