Chapter 34: Complementary & Alternative Therapies in Care

The text emphasizes the critical role of the nurse in promoting patient safety through cultural competence and rigorous health history assessments, specifically identifying the use of various healing modalities ranging from prayer and massage to herbal supplements and energy work. A significant portion of the discussion focuses on the regulatory landscape, noting that while the FDA regulates drugs, many herbal products and dietary supplements fall under the Dietary Supplement Health and Education Act (DSHEA), often leading to inconsistencies in strength, purity, and safety labeling. The chapter details specific mind-body therapies such as guided imagery, biofeedback, and hypnotherapy, which are increasingly utilized for pain management during labor and for behavioral conditions like ADHD in children. It also explores manipulative and body-based methods, including chiropractic care, osteopathy, and massage, while issuing a vital warning that practices like "cao-gio" or coin rubbing can leave marks mistakenly identified as child abuse. Energy therapies are examined, explaining concepts like meridians, chi, and dermatomes in acupuncture and acupressure, alongside the use of TENS units for nausea control. The summary highlights essential pharmacological and physiological safety considerations, such as the distinct metabolic differences in infants that make them more susceptible to toxicity from herbal remedies. Detailed contraindications are provided for the maternity patient, including the avoidance of specific essential oils and herbs that may act as uterine stimulants or teratogens. The chapter explicitly lists herbs that must be discontinued two weeks prior to surgery—such as garlic, ginger, ginkgo biloba, and ginseng—due to risks involving coagulation and hemodynamic instability. Furthermore, it addresses the use of Hyperbaric Oxygen Therapy (HBOT) for wound healing and carbon monoxide poisoning, while noting its contraindication during pregnancy due to the risk of closing the fetal ductus arteriosus. Finally, the content underscores the importance of the nurse's non-judgmental approach in documenting CAM use to prevent dangerous drug-herb interactions, such as those seen with St. John's Wort or anticoagulants, ensuring an integrative approach that respects family beliefs while maintaining medical safety.