Instructions: These are clinical vignettes in relation to the synthesis and application of the nursing

process and the lesson on CAM techniques. Answer the question/s in bold letters per number in the
most thorough manner with at least two to three references. Also find a related research
journal/article (2015 up to the present) for each clinical vignette.

1. Rina, a 76-year-old obese woman tells you that she wishes to exercise, but she can never bring herself
to begin an exercise program. She knows that her hypertension, diabetes, and high cholesterol would
benefit from regular exercise. She is caring for her grandchildren 3 days per week and cannot find the
time to engage in regular exercise. She is not sure if it is safe to walk alone around her neighborhood,
anyway. Explain how you can help Rina begin an exercise program. What benefits might she
obtain through regular exercise? How frequently should she plan to exercise? How will you
apply the principles of CAM Techniques?

I can be of help to Rina start an exercise routine by highlighting the importance of doing so
and the benefits she will obtain from doing so. Diabetics require exercise in order to maintain
control of their blood sugar levels. Exercise is also necessary for lowering cholesterol levels. It
may help to raise HDL cholesterol, which helps to protect against heart disease. It may, in rare
situations, aid in the reduction of LDL cholesterol levels. After a meal, Rina's best hope for
stabilizing her blood sugar levels is to go for a walk. On a regular basis, physical activity is
incorporated into the plan. Most, if not all, days of the week, she should strive to receive at
least 30 minutes of moderate activity. Many individuals believe that brisk walking is a great
way to exercise.

Brisk walking, according to many individuals, is a fantastic place to start. She can begin using
yoga as a complementary and alternative medicine treatment. The concept of healing by touch
assumes that a disease or injury in one portion of the body can impact the entire body. If the
remainder of the body can be brought back to full health through manual manipulation, the
body can focus only on repairing the damaged or unwell area. Treatments for both the body
and the mind are frequently combined. Diet, on the other hand, can be used to promote
holistic recovery. Healing is possible if everyone is given the time and attention they need. In
Mrs. Rina's situation, a low-fat, low-sugar, and low-carbohydrate diet can reverse and control
her condition. salt diet or switching to a vegetarian diet that includes more fresh veggies, both
of which are currently available in her neighborhood. She can at the very least expect an
improvement in her health if she combines two of the new lifestyle techniques for her. Her
health, as well as her total well-being, has improved. In my profession as a healthcare provider,
I've seen a lot of these kinds of occurrences. Positive reinforcements should be handled for
them, just as they should be for her, because one of their main challenges is their desire to be
healthier. Nurses should be able to direct youngsters in the right direction. Every step of the
way, with patience and compassion, until it becomes a natural part of their lives.
References:

Institute of Medicine (US) Committee on the Use of Complementary and Alternative Medicine by the American
Public. Complementary and Alternative Medicine in the United States. Washington (DC): National Academies
Press (US); 2005. APPENDIX A, CAM Therapies, Practices, and Systems. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK83796/

https://www.cancer.gov/about-cancer/treatment/cam

Bower TN, Muhsen S, Overbury O, Birt C, Kasner O. Canadian opthalmologists' opinions concerning
complementary and alternative medicine (CAM) use in diabetes. 2014;23(7):430-4.

2. Mr. Johnny complains that he has been falling a lot recently. He can remember at least three falls in the past 6
months, but luckily none resulted in injury yet. His friend is living in a nursing home as a result of complications
and debility that followed a hip fracture, and Mr. Johnny does not want the same fate for himself.  Describe how
you will assess and manage Mr. Johnny’s fall risk. What specific CAM Techniques do you propose that
the patient have?

I'll perform a single leg stance test and a Timed Up and Go (TUG) test to assess his current
position. Previous falls are the most significant markers of risk, and damaging falls, as well as
walking or balance difficulties, increase the risk even more. Balance screening checks can assist
determine who needs to improve their balance and who would benefit from an exercise
program. A more thorough multifactorial evaluation may be required for high-risk patients. I'll
also complete important aspects of a multifactorial evaluation, such as a detailed falls history,
medication review, and risk factor assessment, which covers osteoporosis, urinary incontinence,
and cardiovascular disease. Furthermore, elderly people with musculoskeletal issues including
joint pain and osteoarthritis seek for complementary and alternative therapy. Exhaustion, sun
exposure, and milk drinking can all produce gallstones. He needs vitamin D and calcium, as well
as regular eye exams, to maintain his eyesight healthy. ophthalmologists to see if his vision has
to be addressed in order to cut down on the time he spends in front of the computer. Wet
bathroom floors, toys, and dim illumination are all potential hazards in the home. Stairs and
carpets that needed to be reinforced or removed Apart from this, I would advise him to relax
by doing stretching exercises, yoga, Shang Chi, and gentle aerobics. He works to keep his
body's strength and flexibility, as well as his balance and coordination, in good shape.

References:

https://www.medicinenet.com/alternative_medicine/article.htm

Antov, H., Jablonski, R., Keeling, A. et al. CAD/CAM techniques for the conservative and efficient management
of tooth wear. Br Dent J 227, 791–796 (2019). https://doi.org/10.1038/s41415-019-0889-z

Alternative Medical Practices, NIH: National Center for Complementary and Alternative Medicine,
http://www.nlm.nih.gov/medlineplus/complementaryandalternativemedicine.html
 3. Mrs. Georgette is a 92-year-old woman with Alzheimer’s disease. Her daughter is her primary
caregiver and calls to report that caring for her mother has become intolerable. “I cannot make her eat,
drink, or stop her incessant whining.” You notice that Mrs. Georgette has not been in to see her primary
care physician in more than 3 years, but that she has been in too the Emergency Department four times
in the past year for dehydration, urinary tract infections, and behavior management. You want to assess
the home situation for safety and provide caregiver support for the patient’s daughter. What signs of
abuse and neglect might you look for through a chart review? Through a clinic visit and
evaluation of the client? Through laboratory testing? How could you get a better assessment of
the actual home situation? If your suspicions are strengthened, how will you proceed to
intervene with this case of suspected elder abuse and neglect? 

As a nurse, I'll investigate the signs and symptoms of physical, sexual, and emotional abuse.
Emotional, psychological, and linguistic environments If you notice indicators like bruising or a
reluctance to walk, it's time to contact a doctor. Speech, shriveled personality, malnourishment,
and missed/overused drugs should all be recorded and considered as evidence and a basis for
action over a long period of time. Right immediately, I'm going to alert both the hospital and
the government authorities. If you're in, I'll take over if a caregiver is unable to meet the
elderly's needs. Collaborate with government officials to provide refugees with suitable and
secure lodging. I'd also investigate the situation from the standpoint of an institution that has
worked with law enforcement and inspectors to either revoke the caregiver's authority to care
for them, or to permanently close the care facility and compensate the grieving person and
their loved ones for the losses they've suffered.

One-step screening with the EASI is indicated when a physician has known a normally
functioning, cognitively intact patient for a long time. A complete medical and surgical history
should be gathered, as well as a comprehensive medication evaluation, which should include
determining who is responsible for delivering and maintaining the patient's medications. Due
to an older patient's neurologic, cognitive, or psychiatric impairments, as well as family
relations, obtaining a trustworthy history may be challenging. Disclosure may be difficult due
to fear of retaliation, shame, dependency on the caregiver, and a lack of privacy. According to a
study, nurses should encourage patients and caregivers to offer complete information by
asking neutral, nonjudgmental questions. Whenever feasible, it is vital to interview the patient
alone. Furthermore, there are no reliable scientific tests for detecting consumption.
Undetectable amounts of prescription drugs may suggest medication withholding, which is
considered neglect in the case of a dependent elderly person with cognitive impairment.
Controlled drugs may be diverted by caregivers for illegal use. A deliberate or unintentional
overdose could be indicated by increased therapeutic pharmaceutical levels without a medical
rationale. Poisoning can be indicated by the presence of non-prescribed medications or other
poisons. To rule out irregular or severe bruising, coagulation testing and a platelet count can
be utilized. Hospitalization may be required, depending on the severity of the offense, to give
treatment and protection while the case is investigated or a judicial inquiry is held.

A safety plan helps the patient identify options and proposes strategies to increase his or her
own safety. Each plan should be unique, written down, stored safely, and reviewed on a regular
basis by the physician, the patient, and a trusted friend or family member.
References:
Analysis of the Effects of Complementary and Alternative Medicine (CAM) Methods to Decrease Body Image
Dissatisfaction among Young Women during 2015-2020 and A Research Protocol—ScienceDirect. (n.d.). Retrieved
December 9, 2021, from https://www.sciencedirect.com/science/article/pii/S2772371221000073

Complementary and Alternative Medicine (CAM). (n.d.). Retrieved December 9, 2021, from
https://www.webmd.com/balance/guide/what-is-alternative-medicine

Complementary and Alternative Medicine for Victims of Intimate Partner Abuse: A Systematic Review of Use and
Efficacy. (n.d.). Retrieved December 9, 2021, from https://www.hindawi.com/journals/ecam/2014/963967/