Pharmacology · chapter 5 · Fluids and Electrolytes, Vitamins, Minerals, and Alternative Therapies
Vitamins, Minerals, and Complementary and Alternative Therapies
The 13 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.
Key points
When vitamins are prescribed
Vitamins are usually prescribed for clients who have the inability to metabolize and absorb vitamins, such as with celiac disease; increased vitamin losses, such as with diarrhea and crash diets; and when there is an increased vitamin need, such as with pregnancy.
Water-soluble vitamins are not stored
They are excreted by the kidneys in urine and are minimally stored in the body. Water-soluble vitamins need to be consumed regularly in the diet or through supplements to maintain adequate levels in the body.
Fat-soluble vitamins are stored
Fat-Soluble Fat-soluble vitamins dissolve in fat and are stored in the body’s fat tissues and liver. They are absorbed along with dietary fat and can be stored in the body for extended periods.
Fat-soluble vitamin toxicity
Excessive intake of fat-soluble vitamins can lead to toxicity because they are not readily excreted.
What minerals do
Minerals are necessary for the formation of strong bones and teeth, regulation of fluid balance, muscle function, and the production of hormones and enzymes. They aid in the transport of oxygen and nutrients throughout the body and support immune function.
Chelating agents for iron overload
Deferoxamine, deferasirox, and deferiprone bind to excess iron in the body, forming a complex that can then be excreted in the urine or feces. They are used to treat iron overload conditions such as h emochromatosis or thalassemia.
Chelating agents for copper
Penicillamine and trientine bind to excess copper and form a complex that can be excreted in the urine. They are used to treat Wilson’s disease, a genetic disorder that causes copper to accumulate in the liver and brain.
Chelating agents for lead
Dimercaprol, EDTA, and succimer bind to lead in the body, forming a compound that is excreted in the urine or feces; they are used to treat lead poisoning and reduce the body burden of lead.
Not all CAM is safe
However, it is important to note that not all CAM therapies are safe and effective, and some may even be harmful.
Supplements are regulated as food
Under DSHEA, dietary supplements are classified as a food, not a drug, and are not subject to the same strict regulations as drugs.
What GMPs require
GMPs require manufacturers to use standardized manufacturing processes, perform regular testing of raw materials and finished products, and maintain detailed records of all production and testing.
Complementary therapies do not replace care
They are often used to alleviate symptoms and side effects associated with medical conditions and treatments, but they are not intended to replace or serve as a substitute for traditional medical care.
Medical cannabis and the nurse
With the increasing use of medical cannabis, there is a growing need for health care professionals to be trained in its use and to be able to provide accurate information to clients.
Terms to know
- Vitamins
- Vitamins Vitamins are essential organic compounds required for normal metabolic function, growth, and healing.
- Complementary and alternative medicine (CAM)
- Complementary and Alternative Therapies Complementary and alternative therapies, also known as complementary and alternative medicine (CAM), is a broad term used to describe health practices and treatments that are used in addition to or instead of conventional medical therapies.
- Dietary Supplement and Health Education Act (DSHEA)
- Dietary Supplement and Health Education Act The Dietary Supplement and Health Education Act (DSHEA) of 1994 is a federal law that regulates the manufacturing and labeling of dietary supplements.
- Good Manufacturing Practices (GMPs)
- Good Manufacturing Practices Good Manufacturing Practices (GMPs) are a set of guidelines established by the FDA that ensures quality, purity, and strength of dietary supplements.
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
The graded version needs JavaScript. Every question is below anyway, with the answer and why.
Every question here, with the answer
A client takes high-dose vitamin A and vitamin D supplements every day and says, "Vitamins are natural, so extra can't hurt." How should the nurse respond?
- Only water-soluble vitamins can cause toxicity.
- That is correct; extra vitamins are excreted in the urine.
- Fat-soluble vitamins like A and D are stored in the body, so taking too much can cause toxicity.
- Vitamins A and D are water-soluble and need daily replacement.
Answer: Fat-soluble vitamins like A and D are stored in the body, so taking too much can cause toxicity.
Vitamins A and D are fat-soluble; they are stored in fat tissue and the liver and are not readily excreted, so excess can lead to toxicity. It is water-soluble vitamins that are excreted in urine and minimally stored.
A client on an anticoagulant tells the nurse she has started taking ginger for motion sickness. What is the nurse's best response?
- Ginger will make the anticoagulant work less well, so double the dose.
- Ginger is safe with any medication.
- Ginger affects blood clotting and is contraindicated with anticoagulants; talk to your provider.
- Take the ginger at a different time of day than the anticoagulant.
Answer: Ginger affects blood clotting and is contraindicated with anticoagulants; talk to your provider.
Ginger affects blood clotting and is contraindicated for clients on anticoagulants, so the client should stop and discuss it with the provider. Separating doses does not remove the effect, and changing the anticoagulant dose on her own is unsafe.
A client asks the nurse about taking St. John's wort for depression. Which points should the nurse include? Select all that apply.
- It may interact with other antidepressants.
- It is regulated as a drug by the FDA.
- It may interact with digoxin and theophylline.
- It may interact with hormonal contraceptives.
- It should not be taken during pregnancy or breastfeeding.
Answer: It may interact with other antidepressants., It may interact with digoxin and theophylline., It may interact with hormonal contraceptives., It should not be taken during pregnancy or breastfeeding.
St. John's wort may interact with other antidepressants, theophylline, digoxin, hormonal contraceptives and some anticancer drugs, and should not be taken in pregnancy or breastfeeding. Under DSHEA, dietary supplements are classified as food, not drugs.
A client with diabetes who takes medication for blood glucose says he now takes garlic daily for heart health. What should the nurse monitor for?
- Hypoglycemia
- Weight gain
- Hyperglycemia
- Hyperkalemia
Answer: Hypoglycemia
Garlic lowers blood glucose and may cause hypoglycemia in clients already taking diabetes medication. Garlic does not raise glucose, and the other findings are not linked to garlic in the section.
A client who takes a CNS depressant for sleep asks about herbal products. Which herbal remedies should be used cautiously or avoided with CNS depressants? Select all that apply.
- Hawthorn
- Saw palmetto
- Valerian
- Turmeric
- Echinacea
Answer: Hawthorn, Valerian
Valerian should not be used with CNS depressants because it may cause severe sedation, and hawthorn may potentiate CNS depressants. Echinacea, saw palmetto and turmeric have other precautions (liver toxicity, finasteride, bleeding) but not CNS depressants.
A child is diagnosed with lead poisoning. Which drug does the nurse expect to be ordered to remove the lead?
- Deferoxamine
- Trientine
- Succimer
- Penicillamine
Answer: Succimer
Dimercaprol, EDTA and succimer bind to lead so it can be excreted. Deferoxamine binds excess iron, and penicillamine and trientine bind excess copper in Wilson's disease.
Where every quote comes from
Section 5.4 Vitamins, Minerals, and Complementary and Alternative Therapies of Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris, Dorie Weaver, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.