Complementary and Alternative Therapies/Pain Management

Question 1

Define complementary and alternative medicine.

Answer 1

an array of health care approaches with a history of use or origins outside of mainstream medicine.

Question 2

What are complementary therapies?

Answer 2

(integrative therapies) therapies used in addition to or together with conventional treatment recommended by a person’s health care provider

Question 3

What are some examples of complementary therapies?

Answer 3

therapeutic touch, guided imagery, massage, reflexology, prayer, hypnotherapy, creative therapies

Question 4

How do alternative therapies differ and how are they the same as complementary therapies?

Answer 4

Alternative therapies become the primary treatment and replace conventional medical care but may include same interventions as complementary therapies.

Question 5

What are alternative therapies?

Answer 5

Therapies based on (allopathic) conventional pathophysiology and anatomy while acknowledging the mind-body connection.

Question 6

What are Whole Medical Systems?

Answer 6

Therapies based on completely different philosophies and life systems than those used by allopathic (conventional) medicine.

Question 7

What types of therapy is included in Whole Medical Systems?

Answer 7

traditional Chinese medicine, Ayurveda (practiced in India), and Naturopathy

Question 8

What is Integrative health care?

Answer 8

Health care that emphasizes the importance of the relationship between practitioner and patient, focuses on the whole person, and informed by evidence.

Question 9

relaxation response

Answer 9

the state of generalized decreased cognitive, physiological, and/or behavioral arousal

Question 10

progressive relaxation

Answer 10

training that teaches a person how to effectively rest and reduce tension in the body.

Question 11

passive relaxation

Answer 11

the process of calming the mind and body intentionally without the need to tighten and relax any particular body part.

Question 12

What is a limitation of relaxation therapy?

Answer 12

increased sensitivity in detecting muscle tensions

Question 13

Meditation

Answer 13

any activity that limits stimulus input by directing attention to a single unchanging or repetitive stimulus (person becomes more aware of self)

Question 14

What is a benefit of mediation?

Answer 14

lowers O2 consumption
reduces RR and HR
reduces anxiety
lowers BP

Question 15

What are some limitations of meditation?

Answer 15

• may become hypertensive

- may enhance effects of certain drugs

Question 16

Imagery

Answer 16

a mind-body therapy that uses the conscious mind to create mental images to stimulate physical changes in the body, improve perceived well-being, and/or enhance self-awareness

Question 17

What is a benefit of imagery?

Answer 17

pain control

Question 18

What are the limitations of imagery?

Answer 18

none - very few side effects

Question 19

Biofeedback

Answer 19

a mind-body technique that uses instruments to teach self-regulation and voluntary self-control over specific physiological responses. (immediate feedback is provided)

Question 20

What is the intended purpose of acupuncture?

Answer 20

it regulates or realigns vital energy (qui), which flows through channels in the form of a system of pathways called meridians.

Question 21

What is a desired effect of acupuncture?

Answer 21

pain relief

Question 22

What is the intended purpose of therapeutic touch?

Answer 22

to affect energy fields with conscious intent to help or heal

Question 23

What are the 5 phases of therapeutic touch?

Answer 23

1. centering
2. assessing
3. unruffling
4. treating
   5 evaluation

Question 24

What is the basis of Traditional Chinese Medicine?

Answer 24

“Life in balance”

Health promotion based on Yin and Yang - opposing, complementary forces that exist in dynamic equilibrium

Question 25

What are the methods of evaluation in traditional chinese medicine?

Answer 25

- Observing - Hearing/smelling - Asking/interviewing - Touching/palpating

Question 26

natural product

Answer 26

a chemical compound or substance produced by a living organism

Question 27

physical dependence

Answer 27

a state of adaptation that is manifested by a drug class-specific withdrawal syndrome produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist

Question 28

addiction

Answer 28

a primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations

Question 29

drug tolerance

Answer 29

a state of adaption in which exposure to a drug induces changes that result in a diminution of one or more effects of the drug over time

Question 30

placebos

Answer 30

pharmacologically inactive preparations or procedures that produce no beneficial or therapeutic effect.

Question 31

Acute/transient pain

Answer 31

pain that is protective, usually has an identifiable cause, is of short duration, and has limited tissue damage and emotional response - usually reversible

Question 32

Chronic/persistent noncancer pain

Answer 32

pain that is NOT protective, lasts longer than 3 mos., has no purpose, and may or may not have an identifiable cause

Question 33

Chronic episodic pain

Answer 33

pain that occurs sporadically over an extended duration

Question 34

Cancer pain

Answer 34

can be acute or chronic

Question 35

idiopathic pain

Answer 35

chronic pain without identifiable physical or psychological cause

Question 36

nociceptive pain

Answer 36

pain that results from damage to body tissue described as sharp, aching or throbbing

Question 37

What are the two classifications of nociceptive pain?

Answer 37

Somatic: comes from bone, joint, muscle, skin, or connective tissue Visceral pain: arises from visceral organs such as the gastrointestinal tract and pancreas

Question 38

What are the two classifications of neuropathic pain?

Answer 38

Centerally generated: CNS or ANS | Peripherally generated: polyneuropathies and mononeuropathies

Question 39

breakthrough pain

Answer 39

severe pain that erupts while a patient is already medicated with a long-acting painkiller.

Question 40

What are some types of breakthrough pain?

Answer 40

- incident pain: predictable and elicited by specific behaviors or triggers such as a voluntary act (walking), involuntary act (coughing) or treatments (dressing changes) - end-of-dose pain: occurs toward the end of the usual dosing interval of a regular scheduled analgesic - spontaneous pain: unpredictable and not associated with any activity or event

Question 41

What are the four physiological processes of normal pain?

Answer 41

1. Transduction: converts energy produced by the stimuli into electrical energy 2. Transmission: sending of impulse across a sensory pain nerve fiber (nocicpter) 3. Perception: the point at which a person is aware of pain 4. Modulation: inhibits pain impulse (protective reflex)

Question 42

What are physiological factors that influence pain?

Answer 42

age, fatigue, genes, neurological function

Question 43

What are social factors that influence pain?

Answer 43

attention, previous experiences, family and social support, spiritual

Question 44

What are psychological factors that influence pain?

Answer 44

anxiety, coping style

Question 45

What is the ABCDE routine clinical approach to pain assessment?

Answer 45

1. Ask about pain regularly 2. Believe the patient 3. Choose appropriate pain control options 4. Deliver timely and logical interventions 5. Empower patient

Question 46

What are characteristics of pain?

Answer 46

``` Timing Location Severity Quality Aggravating factors Relief measures ```

Question 47

What are some possible sources for errors in pain assessment?

Answer 47

``` Bias Vague or unclear questions Inappropriate assessment tools Inappropriate medical terms Unclear patients cognitively impaired patients ```

Question 48

What are some nursing diagnoses relating to pain?

Answer 48

``` Activity Intolerance Fatigue Impaired social interaction Anxiety Insomnia Ineffective coping Impaired physical mobility ```

Question 49

What are the three types of analgesics?

Answer 49

1. nonopioids 2. opioids 3. co-analgesics or adjuvants

Question 50

What type of pain are nonopioids used for?

Answer 50

mild to moderate pain

Question 51

What type of pain are opioids used for?

Answer 51

moderate to sever pain

Question 52

What are adjuvants?

Answer 52

drugs used to treat other conditions but they also have analgesic qualities