Case Study chapter 9 PDF

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CaseSt udy Chapt er9:I nt egr at i veMedi ci neandAl t er nat i veTher api es Ms. Alice Wilkerson, a 45-year-old female, is being seen at the clinic for an annual checkup. She told the nurse that she has been experiencing menopausal symptoms: night sweats, mood swings, and hot flashes. She stated she visited WebMD at http://www.webmd.com/menopause/guide/menopause-natural-treatments (Links to an external site.) and also watched a slideshow on various supplements and herbals at http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/slideshowmenopause (Links to an external site.). She would like to find out if it is alright with her physician to take Black Cohosh to help alleviate hot flashes, night sweats, and mild mood swings. She wants to make sure there are no potential drug interactions with the herbal supplement. She stated that she can’t stand the taste of soy milk or flax seed, so she felt these were not choices she could try. She also wonders if she needs to supplement calcium and vitamin D in her diet to help avoid developing osteoporosis because she has a history of lactose intolerance. The client also wants to take beginner Yoga classes because she has identified an increase in stress where she works, and she has heard from friends that the classes really helped with their stress and menopausal symptoms. The LPN/LVN places a note to the physician related to the client’s requests on the electronic medical record. The nurse also needs to provide further information on the complementary and alternative therapies the client has requested. (Learning Objective 8)

1.

What is the role the nurse should provide in relation to complementary and alternative therapies?

The nurse’s role is to first understand the use of CAM therapies. They need to know costs, possible interactions caused by the therapies, and they need to gain understanding of the patient’s knowledge. The nurse will need to include relevant information that regards risks and benefits that are associated with the herbal and dietary supplements that the patient is wanting to take, as well as yoga. Secondly, the nurse needs to make sure that he/she supports the client’s decision and allows them to make it themselves. The nurse should not advocate against the client’s decision, rather they should inform them about the products, but not pressure them into choosing other options or deciding against the alternative therapies. The nurse needs to remain holistic and answer any questions that the patient may have about the CAM. Also, the nurse needs to be well educated on herbal supplements, especially Black Cohosh, Calcium, and Vitamin D. 2.

What additional information should the nurse provide to help the client to make informed decisions on over-the-counter herbal supplements?

The nurse needs to make sure that the client understands that OTC drugs are not FDA approved and they may cause adverse reactions or act against medications that they are already taking.

The patient will need to be informed that just because they believe that the herbal supplements are natural, they are not at all risk free and they make cause an allergic reaction. Because the patient wants to use the Black Cohosh for her menopause, the nurse needs to educate the patient that if she has any liver problems that she should not take the supplements. Along with that, she should know that the Black Cohosh is derived from buttercup. Educate the patient on the importance of calcium and vitamin D before taking the supplements. The patient needs to be informed that if she does take calcium to help prevent the development of osteoporosis, due to being younger than the age of 51, she should take no more than 1000 mg of calcium daily, she also needs to know that it’s better for her to take the supplements at 500 mg, along with food. Also regarding Vitamin D, it is found in many foods and she should only take in 600 IU daily, since she is younger than the age of 71. Another option to get enough vitamin d is the sun, unless contraindicated.

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http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/slideshowmenopause (Links to an external site.) Med surge book Chapter 9 http://www.webmd.com/menopause/guide/menopause-natural-treatments (Links to an external site.) https://pubmed.ncbi.nlm.nih.gov/16925002/...