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Nursing re- are best communicated through aesthetic media to sponses to calls for caring evolve as nurses clarify preserve the lived meaning of the situation and the their understandings of calls through presence and openness of the situation as text order 200mg extra super viagra erectile dysfunction onset. Sensitivity and skill in creating unique and effective ways of communicating caring are devel- His eyes meet mine buy extra super viagra 200mg on line impotence exercises for men, oped through intention, experience, study, and Unable to speak, reflection in a broad range of human situations. It is the loving relation into which nurse Our bond is made, Unspoken thoughts, But understood, The caring between is the source and I care for him! Collins (1993) and nursed enter and cocreate by living the inten- Each encounter—each nursing experience— tion to care. In Collins’s reflections, ing between, unidirectional activity or reciprocal he shares a story of practice that illuminates the exchange can occur, but nursing in its fullest sense opportunity to live and grow in caring. It is in the context of the caring be- In the nursing situation that inspired this poem, tween that personhood is enhanced, each express- the nurse and nursed live caring uniquely. This al- particular experience of nursing and linked to a lows him to see past the “anger-filled” room and to general conception of nursing. By living caring moment to moment, hope emerges and fear My hands are moist, subsides. Through this experience, both nurse and My heart is quick, nursed live and grow in their understanding and My nerves are taut, expressions of caring. He’s in the next room, In the first stanza, the nurse prepares to enter the I care for him. Perhaps he It’s anger-filled, has heard a report that the person he is about to en- The air seems thick, counter is a “difficult patient,” and this is a part of I’m with him now, his awareness; however, his nursing intention to I care for him. In the second stanza, the nurse Time goes slowly by, enters the room, experiences the challenge that his As our fears subside, intention to nurse has presented, and responds to I can sense his calm, the call for authentic presence and caring:“I’m with He softens now, him now/I care for him. The nurse listens intently and the College of Nursing at Florida Atlantic recognizes the unadorned honesty that sounds University, where both authors were among the fac- angry and demanding but is a personal expression ulty group revising the caring-based curriculum. The nurse responds with steadfast presence us recognized the potential and even the necessity and caring, communicated in his way of being and of continuing to develop and structure ideas and of doing. The caring ingredient of hope is drawn themes toward a comprehensive expression of the forth as the man softens and the nurse takes notice. The point of departure was the ac- ops, and personhood is enhanced as dreams and as- ceptance that caring is the end, rather than the pirations for growing in caring are realized: “His means, of nursing, and that caring is the intention eyes meet mine... This stanza, the nursing situation is completed in linear work led to the statement of focus of nursing as time. But each one, nurse and nursed, goes forward, “nurturing persons living caring and growing in newly affirmed and celebrated as caring person, and caring. The clarified focus and the idea of the nurs- In Collins’s poem, the power of the basic assump- ing situation are the key themes that draw forth the tion that all persons are caring by virtue of their meaning of the assumptions underlying the theory humanness enabled the nurse to find the courage to and permit the practical understanding of nursing live his intentions. As critique of and complete in the moment permits the nurse to the theory and study of nursing situations pro- accept conflicting feelings and to be open to the gressed, the notion of nursing being primarily con- nursed as a person, not merely as an entity with a cerned with health was seen as limiting, and we diagnosis and superficially or normatively under- now understand nursing to be concerned with stood behavior. Person- human mode of being was incorporated into the hood, a way of living grounded in caring that can most basic assumption of the theory. We view be enhanced in relationship with caring other, Paterson and Zderad’s (1988) existential phenome- comes through in that the nurse is successfully liv- nological theory of humanistic nursing as the his- ing his commitment to caring in the face of diffi- torical antecedent of nursing as caring. Seminal culty and in the mutuality and connectedness ideas such as “the between,” “call for nursing,” that emerged in the situation. Schoenhofer’s Nursing as Caring Theory 339 substantive and structural bases for our conceptu- ment and surveillance techniques. Mayeroff’s (1971) that is an insufficient response—it certainly is not work, On Caring, provided a language that facili- the nursing we advocate. The theory of nursing tated the recognition and description of the practi- as caring calls upon the nurse to reach deep within cal meaning of caring in nursing situations. In a well-developed knowledge base that has been addition to the work of these thinkers, both authors structured using all available patterns of knowing, are long-standing members of the community of grounded in the obligations and intentionality in- nursing scholars whose study focuses on caring and herent in the commitment to know persons as who are supported and undoubtedly influenced in caring. These patterns of knowing may develop many subtle ways by the members of this commu- knowledge as intuition; scientifically quantifiable nity and their work. All knowledge the first complete exposition of the theory pre- held by the nurse that may be relevant to under- sented at a theory conference in 1992 (Boykin & standing the situation at hand is drawn forward Schoenhofer, 1990, 1991; Schoenhofer & Boykin, and integrated as understanding that guides prac- 1993), followed by the work, Nursing As Caring: A tice in particular nursing situations (aesthetic Model for Transforming Practice, published in 1993 knowing). Although the degree of challenge pre- (Boykin & Schoenhofer, 1993) and re-released with sented from situation to situation varies, the com- an epilogue in 2001 (Boykin & Schoenhofer, 2001). The challenge for nursing, then, is not to (Boykin & Schoenhofer, 1997; Schoenhofer & discover what is missing, weakened, or needed in Boykin, 1998a, 1998b), and in consultation with another, but to come to know the other as caring graduate students, nursing faculties, and health- person and to nurture that person in situation- care agencies who are using aspects of the theory to specific, creative ways and to acknowledge, support, ground research, teaching, and practice. We no longer understand nursing as a “process” in the sense of a complex sequence of predictable acts resulting Applications in some predetermined desirable end product. This implies that the nurse comes to know the other as a caring person in the moment. Nursing which the focus of nursing is on nurturing persons practice leaders who recognize their care role, as they live caring and grow in caring. All activities in the practice of nursing administration are Nursing practice leaders who recognize grounded in a concern for creating, maintaining, their care role, indirect as it may be, are and supporting an environment in which calls for in an excellent position to act on their nursing are heard and nurturing responses are given committed intention to promote caring (Boykin & Schoenhofer, 2001). Participating in rigorous negotia- trator is intimately involved in multiple nursing sit- tions for fiscal, material, and human resources uations simultaneously, hearing calls for nursing and for improvements in nursing practice calls and participating in responses to these calls. As calls for special skill on the part of the nurse adminis- for nursing are known, one of the unique responses trator—skill in recognizing, acknowledging, and of the nursing administrator is to enter the world of celebrating the other (e. The nurse stand special calls when they occur, and to assist in administrator who understands the caring ingredi- securing the resources needed by each nurse to nur- ents (Mayeroff, 1971) recognizes that caring is nei- ture persons as they live and grow in caring (Boykin ther soft nor fixed in its expression. All administrative activities understanding of the caring ingredients helps the should be approached with this goal in mind. Here, nurse administrator mobilize the courage to be the nurse administrator reflects on the obligations honest with self and other, to trust patience, and to inherent in the role in relation to the nursed. The value alternating rhythm with true humility while presiding moral basis for determining right action living a hope-filled commitment to knowing self is the belief that all persons are caring. The nursing administrator assists others within the organization to understand the focus of From the perspective of nursing as caring, all struc- nursing and to secure the resources necessary to tures and activities should reflect the fundamental achieve the goals of nursing. Other assumptions and values re- similar to those of the practitioner and often walks flected in the education program include: knowing a very precarious tightrope between direct care- the person as whole and complete in the moment givers and corporate executives. The nurse adminis- and living caring uniquely; understanding that per- trator, whether at the executive or managerial level sonhood is a way of living grounded in caring and of the organizational chart, is held accountable for is enhanced through participation in nurturing re- “customer satisfaction” as well as for “the bottom lationships with caring others; and affirming nurs- line. Schoenhofer’s Nursing as Caring Theory 341 The curriculum, the foundation of the educa- ing ways to inspire. The humility of unknowing, tion program, asserts the focus and domain of joined with courage and hope, helps the nurse edu- nursing as nurturing persons living caring and cator to guide the study of nursing as a commit- growing in caring: ment to knowing and nurturing persons as caring. The model for organizational design of nursing edu- Many nurse educators are struck with the incon- cation is analogous to the dancing circle.... Members gruity of instilling a commitment to nursing as an of the circle include administrators, faculty, col- opportunity to care through means that seem to leagues, students, staff, community, and the nursed. Nursing dancer to understand and support the study of the education practiced from the perspective of nurs- discipline of nursing. The role of education adminis- ing as caring opens the way for faculty to truly trators in the circle, represented by deans and depart- value the discipline and the student.

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F-test purchase 200mg extra super viagra erectile dysfunction pills herbal, t-test); if tests of distribution show that data are not normally distributed cheap 200mg extra super viagra overnight delivery erectile dysfunction solutions pump, then logarithmic transformation can render data often more normal; otherwise data are analysed by nonparametric statistical techniques (e. Spearman rank correlation, Mann–Whitney U-test); in normally or symmetri- cally distributed data description by the mean and standard deviation is appro- priate; for skewed data the median is a better measure of the center of the 73 distribution and as a measure of the spread the range itself or the interquartile range (percentile r. Australia (since January 1993) and Canada (“Ontario Guidelines”, since 1994), European regulatory authorities are expected to follow (guidelines under development e. The endo- cannabinoid system is vital for the maintenance of homeostasis and can be found in all higher organisms and organs. They are pro- duced by the pituitary gland and the hypothalamus in vertebrates during strenu- ous exercise, excitement, and orgasm; and they resemble the opiates in their abilities to produce analgesia and a sense of well-being. E work as “natural fever relievers”, whose effects may be enhanced by other medications. The first phase (Phase I) assesses the exposure of the environment to the active substance and/ or its metabolites. If a risk is detected, then the fate and effects of the active substance and/or its metabolites in the relevant compartment should be adequately investigated in Tier B. The legal status, constitution, and regulatory requirements may differ among coun- tries”; see also annual progress report, institutional review board, steering committee. EudraPharm Stands for: European Union Drug Regulating Authorities Pharmaceutical Database; data base of all medicinal products with a marketing authorisation in the European Community; the data base includes the Summary of Product Characteristics; part of the database is open to the general public (EudraPharm); http://eudrapharm. European Pharmacopoeia (Eur Ph) Pharmacopoeia published by the Council of Europe; see international non-proprietary name, pharmacopoeia. Fibonacci search scheme dose escalation strategy in phase I clinical trials in oncology; the genuine F scheme is 1, 2, 3, 5, 8, 13, 21, 34 a. Framingham study A cohort study that started in 1948 in a relatively small town (Framingham) in Massachusetts, U. Inadequacy to produce a results or bring about a required end; etymology: futilis – that easily pours out, leaky, hence untrustworthy, vain, use- less (Oxford Dictionary). Intervention has no pathophysiologic benefit; uncer- tain or controversial benefits; burdens/harms/costs outweigh the benefits; intervention has already failed in the patient, maximal treatment is failing. Gantt who developed a graphic charting system to depict activities across a timescale; the chart displays each task as a bar, which shows the task’s start and finish dates and duration on a time scale; see project management. Gehan’s design Useful for rejecting a drug (or hypotheses) from further study; usually there is no control group and the design can be kept unblinded when treatment results are objective resp. The code uses sets of three nucleotide bases (codons) to make the amino aids that, in turn, constitute proteins. Japan) guidelines for monitoring prescription drugs, new chemical enti- ties, new indications, combinations of drugs, routes of administration, dosages a. Graeco-Latin square Special cross-over design; employs both Latin and Greek letters and allows, in comparison with the latin square d. H half life (t1/2) Time within which half of a substance has been eliminated from the body (time taken for plasma concentrations to fall by 50 %); see clearance, elimination, kinetic, pharmacokinetic, treatment schedule. Havard style of citation Style of citations in scientific journals; refer- ences should be listed in alphabetical order and then by year. Hawthorne effect Study participation per se affects the outcome (it makes patients to feel “important”, thus producing a psychological stimulus and a bet- ter outcome); especially behavioural measures are subject to this effect (e. The Hawthorne Effect was first reported following a research programme investigating methods of increas- ing productivity in the Western Electrical Company’s Hawthorne Works in Chicago during the 1920s and 1930s. The finding of enduring interest was that no matter what change was introduced to working conditions, the result was increased productivity. For example, improving or reducing the lighting in the production areas under test produced similar effects. Subsequently the definition has been broadened; in clinical research it refers to treatment response; see also bias, labelling phenomenon, placebo effect, white-coat hypertension. This includes spending by both public and private sources (including households) on medical services and goods, public health and prevention programmes and administration. Excluded are health-related expenditure such as training, research and environmental health. The two major components of total current health expenditure are: expenditure on personal health care and expenditure on collective services. Heaton–Ward effect Subjective assessments can be severely biased by viola- tion of blinding or the expectation of the observer: in a supposed cross-over trial the observer is likely to report a deterioration after cross-over if he initially assumed an improvement and an improvement in those he first imagined had not occurred; see also bias, blinding, design. Certain exudates that have not been subjected to a specific treatment are also considered to be herbal substances. Hochberg correction In order to avoid errors by repeated significance testing the signi fi cance level is divided by the number of comparisons; see also bonferroni correction. An illness is treated with a medicine which could produce similar symptoms in a healthy person. The active ingredients are given in highly diluted form to avoid toxicity”; homeopathic remedies are virtually 100 % safe; see also allopathy. Hygiene program Procedures relating to health, hygiene and clothing of personnel during manufacturing; see good manufacturing practice, loi huriet. Secreted antibodies bind to antigens on the surfaces of invading microbes (such as viruses or bacte- ria), which flags them for destruction. Many are cell growth factors that accelerate the production of specific cells that are important in mounting an immune response in the body. It was originally proposed 50 years ago as a measure of the impact that individual articles have on the research community, but it is now more commonly used across all articles pub- lished by a journal to provide a measure of a journal’s impact on the research community rather than the impact of an individual article. The journal impact factor is thus calculated as the number of citations a journal has received in the last complete year for articles published in the two preceding years, divided by the total number of articles the journal published in the two preceding years. So it gives an average number of citations of published articles, without giving any unfair advantage to the larger or more frequently published journals. Such jour- nal citation reports are used widely as the basis for assessing research output. They are used by funding bodies to gauge the quality of publications, by 120 researchers to assess which journals they choose to submit manuscripts to, and I as a basis for journals to attract new subscriptions and advertising. Conditions, practices or processes that adversely affect the rights, safety or well being of the subjects and/or the quality and integrity of data, or that poses a risk to public health or that represents a serious violation of applicable legislation and guidelines. Conditions, practices or processes that would not be expected to adversely affect the rights, safety or well being of the subjects and/or the quality and integrity of data; see also audit, inspection. I intensive monitoring System of record collation in designed areas such as hos- pitals or physicians in community practice (Vol. Germany), familiar with the back- ground of the drug and the requirements of the study, reputated to have high 131 ethical standards and professional integrity; the legal status of persons autho- rised to act as investigators differs between states; coordinating i. Karch and Lasagna classification see causality; see also standardised assessment of causality. Karnofsky performance status scale which was devised for use in trials of chemotherapeutic agents for carcinoma; 100 % = normal, no complaints, no evidence of disease; 90 % = able to carry on normal activity, minor signs or symptoms of disease; 80 %=normal activity with effort, some signs or symptoms of disease; 70 % = cares for self, unable to carry on normal activ- ity or to do active work; 60 % = requires occasional assistance but is able to care for most of his needs; 50 % = requires considerable assistance and fre- quent medical care; 40 %=disabled, requires special care and assistance; 30 %=severely disabled, hospitalisation is indicated although death is not imminent; 20 %=very sick, hospitalisation necessary, active supportive treatment necessary; 10 % = moribund, fatal processes progressing rapidly; 0 %=dead; this scale however has never been validated; see also perfor- mance status. Korotkoff sound first sound during auscultatory blood pressure measurement: first appearance of faint clear tapping sounds which gradually increase in inten- sity (the systolic pressure is heard for two consecutive beats and this correlates well with intra-arterial pressures; also the pressure at which pulse of arteria radialis/brachialis reappears); fourth sound: point of muffling of sounds, i.

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Note: Decongestant nasal sprays can cause rebound congestion if used longer than three days buy extra super viagra visa reflexology erectile dysfunction treatment. It is most effective as a preventative (before symptoms start) and is available in eyedrops and nasal spray cheap extra super viagra online master card erectile dysfunction is often associated with quizlet. These injections contain purified al- lergen extracts, which desensitize you to allergies. Foods to avoid: • Mucus-forming foods such as dairy products, refined flours, and saturated and hydroge- nated fats can trigger inflammation and should be avoided. Top Recommended Supplements Aller-7: A combination of seven plant extracts that reduces allergy symptoms when taken regularly. Dosage: 660 mg twice daily for six to 12 weeks, then 330 mg twice daily thereaf- ter. Studies used a standardized extract providing 8 mg of petasine (an active chemical) three times daily. Nasaleze: A nasal powder that is inhaled and forms a barrier in the nostrils against allergens. It has no side effects or drug interactions and is safe for children and pregnant women. Sev- eral studies have shown that it reduces allergy symptoms and the need for medication. Complementary Supplements Moducare: A mixture of plant sterols and sterolins (plant fats) that helps balance the im- mune system. Probiotics: Help replenish gastrointestinal flora, which is important for immune function. Vitamin E: Has antioxidant effects and has been shown to reduce allergic response and nasal symptoms (sneezing, itching, stuffiness, and runny nose). Eat plenty of antioxidant-rich fruits and vegetables, especially garlic, onions, and A peppers, nuts, and seeds. It is estimated that 280,600 Canadians over 65 and 50 percent of people over age 85 have A Alzheimer’s disease. These numbers are expected to rise substantially over the next few decades due to our aging population. Alzheimer’s is not a normal part of aging, but it is more common in people as they age. In a healthy brain, there are billions of neurons (nerve cells) that generate elec- trical and chemical signals, which help us think, remember, and feel. In those with Alzheimer’s the neurons begin to die, affecting the normal signalling in the brain. A key feature of this disease is the development of plaques and tangles in the brain. It is thought that a genetic defect in these proteins may be involved in the development of the disease. Tangles refer to a twisting of internal support structures of the brain, which causes damage and death of the neurons. Research has shown that Alzheimer’s disease involves oxidative and inflamma- tory processes, although it is not known whether these processes are a cause or effect of the disease or both. The ultimate result, however, is disruption of neuronal cell functioning and signalling, leading to neuronal cell death, which impairs memory and other mental abilities. There also are lower levels of some neurotransmitters, chemicals in the brain that carry messages back and forth between nerve cells. Although there’s no cure for Alzheimer’s disease, a number of medical advances in recent years and the use of natural supplements can delay the progression of the disease and improve symptoms and quality of life. He described the two hallmark features of the disease—plaques (tiny dense deposits scattered throughout the brain) and tangles (structures of the brain that are twisted)—which interfere with normal brain processes and cause death of brain cells. As the disease A progresses, there is a decline in language skills and the ability to perform tasks. The average length of time from diagnosis of Alzheimer’s to death is about eight years, but some people live beyond 10 years. There are no drugs that can reverse the disease, but there are a few that can help improve cognitive function and slow the cognitive decline associated with Al- zheimer’s, such as Aricept, Reminyl, and Exelon. These drugs improve the levels of neurotransmitters (chemical messengers such as serotonin and acetylcholine) in the brain and can delay the onset of Alzheimer’s in those with mild cognitive impair- ment. Not everyone responds positively to these drugs; some people have to stop because of side effects such as nausea, vomiting, and diarrhea. Two studies have found a lower risk of Alzheimer’s disease with a higher food intake of vitamin E. Boost your intake by eating pumpkin seeds, black-eyed peas, wheat germ, tofu, and seafood. Foods to avoid: • Aluminum has been associated with an increased risk, although the evidence is not conclu- sive. However, it may be wise to avoid aluminum food additives, which are found in some baked goods, processed foods, and beverages. Avoid fast foods, deep-fried foods, and baked goods and margarine containing hydrogenated oils; minimize saturated fat (red meat and high-fat dairy). Being obese and its consequences of high blood pressure and cholesterol are risk factors for Alzheimer’s. According to one study, regular exercises (walking 15 minutes three times per week) reduced the risk of Alzheimer’s and dementia by 40 percent in individuals over age 65. The theory is the more you use your brain, the more synapses you create, which provide a greater reserve as you age. A Bacopa monnieri: An herb that has been shown to enhance several aspects of mental function. It increases availability of acetylcholine in the brain, which improves memory and cognition. Ginkgo biloba: An herb that improves memory and cognitive function and slows the progression of Alzheimer’s. Dosage: 120–240 mg daily, standardized to 6 percent terpene lactones and 24 percent flavone glycosides. Phosphatidylserine: A nutrient that is related to lecithin, which is naturally occurring in the brain. Several studies involv- ing more than 1,000 people suggest that phosphatidylserine is an effective treatment for Alzheimer’s disease and other forms of dementia. It improves both behaviour and mental function and reduces symptoms of depression. Vitamin B1 is involved in nerve transmission and may be deficient in those with Alzheimer’s. Regular consumption of fish reduces Alzheimer’s risk and is important for brain function. Vitamin E: A potent antioxidant that protects the brain from damage due to oxidative stress and inflammation. Higher blood levels of vitamin E are associated with better brain function in older adults and some research has shown that supplements can lower the risk of Alzheimer’s. Consider supplements of acetyl-L-carnitine, bacopa, ginkgo, phosphatidylserine, and fish oils.

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Ephedrine and pseudoephedrine are components of ephedra that have a stimulant and bronchodilation effect buy extra super viagra paypal erectile dysfunction getting pregnant. How- ever discount extra super viagra 200 mg fast delivery erectile dysfunction drugs in nigeria, ephedra has an adverse effect of palpitations—which can result in stroke. Herbal Therapy and the Nursing Process Nurses need to include a discussion about the patient’s use of nonconventional therapeutic agents by name, dosage, frequency, side effects and why the patient is taking this remedy in the nursing assessment. This assessment should include information about all prescription and over-the-counter medications taken by the patient and why the patient is taking these drugs. Herbal medications, over the counter medications, and prescribed medications can combine to create undesir- able results and in some cases can have a toxic and dangerous effect on the patient. After assessing the patient, the nurse considers a nursing diagnosis that is related to herbal therapies. The patient may be unaware of the impact herbal ther- apies have on the patient’s health. The patient may be unaware of how herbal therapies alter the patient’s nutritional balance. The patient might be experiencing nausea, diarrhea, headache, fatigue, and other symptoms that are side effects of herbal therapies. The patient might be experiencing a toxic effect as a result of interactions of herbal therapies with prescribed medications. The patient will verbalize an understanding of the interaction between herbal therapy and conventional therapy. The nurse intervenes by: • Monitoring the patient’s response to conventional and herbal therapy look- ing for adverse side effects. The Do’s and Don’ts About Herbs • Don’t take if pregnant or trying to become pregnant. Make sure that the patient thinks of herbs as medicine that is less potent than conventional medication. However, adverse reactions can occur if conventional medication is taken with herbal therapy. For example, some conventional med- ication may act faster than expected when combined with herbal therapy. The patient should not take any herbal where the following information is not included on the packaging: • Scientific name of the product and the part of the plant used in the preparation • Manufacturer’s name and address • Batch and lot number • Date of manufacture and expiration. It is also a powerful laxative when taken internally and can increase menstrual flow if given in small doses. It is also used in instances where the patient is allergic to daisy or ragweed-like plants. Garlic is also an antibiotic for internal and external treatment of infections and wounds. Ginger is found to relieve nausea and relieves pain, swelling, and stiffness from osteoarthritis and rheumatoid arthritis. Ginkgo has been found useful for treating dementia syndromes, inter- mittent claudication (decreased circulation in the legs), vertigo (dizziness), and tinnitus (ringing in the ears). Red Korean and Chinese Ginseng are used for chronic inflammatory conditions such as arthritis. Hot peppermint tea stimulates circulation, reduces fever, clears congestion, and helps restore energy. Peppermint is also an effec- tive treatment for tension headache when rubbed on the forehead. Some research has shown peppermint to be as effective as Extra-strength Tylenol in relieving headache. Saw Palmetto is also used as an expecto- rant and treatment for colds, asthma, bronchitis, and thyroid deficiency. However, Valerian has an odor of “dirty socks” making it a very low risk for overdose. There have been no reports that frequent use of Valerian leads to habituation and addiction. It also is used to reduce pain and heavy bleeding due to menstrual irregularities and helps to regulate the menstrual cycle. Yarrow enhances circulation, lowers blood pressure, and has an antispasmodic and anti-microbial effect. This results in a lack of standards for the manufacture and sale of herbal therapies. These are oils, balms, creams, ointments, teas, tinctures, capsules, tablets, and syrups. Although herbs are available in these forms, some herbs should only be administered externally and not used internally. While herbal therapies provide patients with a therapeutic effect, they can also leave the patient exposed to hazards. When combined with conventional therapies, herbal therapies can produce a toxic effect or an adverse reaction. The nurse should ask if the patient is taking herbal therapies and, if so, for what condition. The patient should be taught about herbal therapies, the risks and benefits, and then given clear instructions on how to continue herbal thera- pies while undergoing conventional treatment—if approved by the patient’s healthcare provider. The patient should not take an herb unless which of the following infor- mation in on the package? A patient who complains about palpitations and who is undergoing herbal therapy may be taking (a) comfrey. The nurse should instruct the patient on how to monitor for adverse side effects of herbal therapies. Comfrey is an ointment used to relieve swelling associated with abra- sions and sprains. We developed a respect for those words because vitamins and minerals are necessary to remain healthy. Therefore, it is critical that you assess the patient for vitamin and mineral deficiencies and administer the prescribed therapy to restore the patient’s nutritional balance. In this chapter you’ll learn about vitamins and minerals and how to assess patients for deficiencies. You’ll also learn about vitamin therapy and mineral therapy and how to educate your patient about proper nutrition. Vitamins Vitamins are organic chemicals that are required for metabolic activities neces- sary for tissue growth and healing. Under normal conditions, only a small amount of vitamins—which are provided by eating a well balanced diet—are necessary. Likewise, patients who do not have a well-balanced diet (such as the elderly, alcoholics, children, and those who go on fad diets) might also develop a vita- min deficiency.