02.03 Radiation
The nurse is caring for a client who is receiving internal radiation therapy. The client's implant was placed two days ago and is active. Which of the following actions is appropriate for the nurse to limit exposure to the implant? Complete charting outside the room Place them in a negative pressure airflow room Round on them every 2-3 hours instead of hourly Use an intercom to communicate and only enter the room if absolutely necessary
Answer ✅Complete charting outside the room It is important for a nurse to limit exposure to any radiation source. Charting outside of the room limits the time exposed to the radiation. While in general it is best to chart at the bedside, when radiation exposure is a risk, this option is acceptable. Round on them every 2-3 hours instead of hourly Rounding on a client can be done with the same frequency, but instead of entering the room, the nurse can check in from the door and only enter if necessary. Place them in a negative pressure airflow room Radiation is not affected by a negative airflow. Use an intercom to communicate and only enter the room if absolutely necessary An intercom is not necessary, and may feel isolating to the client. An appropriate solution is for the nurse to open the door to talk to the client.
A client with throat cancer is receiving radiation treatment to the head and neck and has developed xerostomia as a result. Which of the following interventions should the nurse suggest to this client? See a dentist to pull any teeth that are causing problems Use a mouthwash that contains fluoride each day Do not eat for 12 hours after the radiation dose Avoiding drinking flavored water or electrolyte solutions
Answer ✅Use a mouthwash that contains fluoride each day Xerostomia, or dry mouth, may occur as a result of decreased saliva production following radiation therapy to the head and neck. To counteract xerostomia and its side effects, the nurse can instruct the client to rinse his mouth each day with a mouthwash that contains fluoride in order to prevent cavities associated with a lack of saliva. The client can also increase his fluid intake to prevent dehydration. See a dentist to pull any teeth that are causing problems Teeth do not cause problems in the client with xerostomia. Rather, a lack of saliva can cause cavities and sores. The client should be encouraged to perform daily mouth checks on herself and regular check-ups with the dentist. Avoiding drinking flavored water or electrolyte solutions The client is encouraged to consume liquids, but should avoid overly sugary, acidic and alcoholic beverages. Frequent sips of water and ice chips are also helpful in alleviating dry mouth symptoms. Do not eat for 12 hours after the radiation dose The client is allowed to eat following their radiation dose. Proper nutrition should be encouraged in the client receiving radiation therapy, as adequate protein and calories are necessary for the client to heal.
A client has undergone external beam radiation to the chest for treatment of lung cancer and is back in their room following the procedure. Which of the following interventions is most appropriate in this situation? Allow visitors to be six feet or more away from the client Assist the client with taking a shower before having visitors Assist the client to bed and allow visitors with no restrictions Place a sign on the door warning visitors of radiation exposure
Answer ✅Assist the client to bed and allow visitors with no restrictions External beam radiation is a process of treating cancer in which a radiation beam is directed to the affected part of the body. Because this is an external dose, the client is not a source of radiation that can be exposed to others and does not need to have restrictions in visitors. Place a sign on the door warning visitors of radiation exposure The client is not a source of radiation and the client does not pose a hazard to anyone else. There is no reason to post a sign warning of radiation exposure. Allow visitors to be six feet or more away from the client This is an unnecessary intervention because the client does not pose a hazard to anyone else. Assist the client with taking a shower before having visitors The client does not pose a hazard to anyone else and a shower, while not contraindicated, is not necessary to perform before having visitors.
A 48-year-old client is undergoing internal radiation for the treatment of kidney cancer. The nurse caring for this client would best protect the client, others, and himself or herself from contamination by which of the following actions? Select all that apply. Wear a film badge to track radiation exposure each time the nurse enters the client's room Ensure that the client is placed in a private room Keep the client's trash can lined with a color coded plastic bag Place a caution sign on the client's door Keep instructions specific to the client's care in a chart in the radiation department
Answer ✅Ensure that the client is placed in a private room The nurse must take several measures for protection when caring for this client including placing the client in a private room. ✅Place a caution sign on the client's door A client who receives internal radiation as part of treatment for cancer can put others at risk of exposure to radiation. The nurse must take several measures for protection when caring for this client by ensuring the client is in a private room and wearing a film badge at all times to track how much exposure has occurred. A color coded liner in the client's trash can will ensure that items or fluids with potential radiation are cleared out of the room and no radiation is lingering in the trash can. The nurse must also keep linens and trash separate from that of other clients to best protect them. Keep instructions specific to the client's care in a chart in the radiation department Storing client care instructions in another department is not helpful nor is it a protective measure. ✅Wear a film badge to track radiation exposure each time the nurse enters the client's room Tracking and controlling the amount of radiation the nurse is exposed to is an important measure that can prevent caregivers from receiving too much radiation in the course of caring for this client. ✅Keep the client's trash can lined with a color coded plastic bag A color coded liner in the client's trash can will ensure that items or fluids with potential radiation are cleared out of the room and no radiation is lingering in the trash can. The nurse must also keep linens and trash separate from that of other clients to best protect them.
A 59-year-old client is undergoing radiation treatment for uterine cancer. Which of the following best describes an acute adverse effect following external radiation therapy to this area? Nephritis Bladder fibrosis Skin erythema Mucous membrane atrophy
Answer ✅Skin erythema Radiation therapy is a form of treatment for cancer. It may be administered externally through passage of a beam of radiation into the body, or through internal placement of a unit of radiation that works within the body. External radiation may cause a number of complications among different body systems, including skin sensitivity and changes to the treated area. Effects on the skin include erythema, irritation, blistering, dry and flaky patches and swelling. Bladder fibrosis The radiation beam is directed at the uterine tissue, and should not affect this area. Nephritis Radiation therapy is precisely directed at the area that needs treatment. The kidneys are not in the path of the radiation beam, and would not be affected. The skin on the outside of the body where the beam enters will become affected, not the kidneys. Mucous membrane atrophy There are no mucus membranes in the path of a radiation beam directed at the uterus.
A nurse is caring for a client the morning after internal radiation therapy for treatment of uterine cancer in which an implant was placed. Which of the following actions demonstrate safe practice by the nurse? Select all that apply. The client is assigned a private room A sign is placed on the door at the beginning of the hallway alerting visitors that a client on the unit has received radiation The nurse does not allow visitors to enter the room The nurse stays at least six feet away from the client if possible The nurse wears a radiation monitor badge for no less than half of the encounters with this client
Answer ✅The client is assigned a private room Internal radiation is a type of cancer treatment that benefits the client but can be damaging to the client's caregivers. The nurse who works with this client should attempt to maintain a distance of six feet between him or herself and the client to minimize exposure. Radiation monitor badges are available that detect radiation exposure, and must be worn at all times when caring for the client. Radiation exposure is best minimized when the nurse spends the least amount of time and the greatest distance away from the client. ✅The nurse stays at least six feet away from the client if possible Internal radiation is a type of cancer treatment that benefits the client but can be damaging to the client's caregivers. The nurse who works with this client should attempt to maintain a distance of six feet between him or herself and the client to minimize exposure. Radiation monitor badges are available that detect radiation exposure, and must be worn at all times when caring for the client. Radiation exposure is best minimized when the nurse spends the least amount of time and the greatest distance away from the client. The nurse wears a radiation monitor badge for no less than half of the encounters with this client The nurse must wear the badge for each encounter with the client. A sign is placed on the door at the beginning of the hallway alerting visitors that a client on the unit has received radiation A sign should be placed on the client's door rather than down the hallway. The nurse does not allow visitors to enter the room Visitors are allowed on a limited basis. They must wear a radiation monitor badge and should be educated to minimize time and maximize distance (at least six feet away) from the client.
A client with a diagnosis of thyroid cancer has recently had internal radiation through brachytherapy. What should the nurse tell the client about visitors when this type of therapy is in place? Visitors must stay at least six feet away from the client Visitors must wash their hands after coming into the room and before leaving The client cannot have any visitors at all All visitors must wear a mask when they enter the room
Answer ✅Visitors must stay at least six feet away from the client Brachytherapy is a form of internal radiation therapy in which an implant is placed in the client's body. The client emits radiation and can present a hazard to others. There are very specific guidelines the nursing staff must follow when assigning and caring for this client. While visitors may still be allowed, they should not have direct contact with the client and should maintain a distance of at least six feet to avoid exposure to the radiation. The client's nurse should limit their time to 30 minutes with the client per shift, and will wear a dosimeter badge to measure their radiation exposure. No pregnant nurse is allowed to care for the client with brachytherapy, and no visitors under 16 or pregnant are allowed. Visitors must wash their hands after coming into the room and before leaving Handwashing will not eliminate the radiation to which the visitor has been exposed. All visitors must wear a mask when they enter the room Wearing a mask is not going to prevent radiation exposure. The client cannot have any visitors at all A client undergoing brachytherapy may have visitors, but they must adhere to guidelines to minimize their radiation exposure during visits.
Following radiation treatment for cancer, a client returns to the room and a sign is placed on the door that says, "Caution: Radioactive Material". Choose the option that best describes how visitors should respond to this sign. Visitors should not enter the room at all Visitors should not be allowed to visit the unit Visitors can spend time with the client but should wear a surgical mask Visitors should limit time with the client
Answer ✅Visitors should limit time with the client Following internal radiation therapy, the client may emit radioactive material from his or her body. A sign should be placed to warn visitors that radioactive material has been used. Visitors may still come to see the client, but they should not stand close to the client and should limit time with the client. Visitors should not enter the room at all A client who has had radiation therapy may have visitors, but others should reduce their exposure to the radiation as much as possible, which includes limiting time spent near the source, making the distance from the source as great as possible, and staying clear of any body fluid from the client. Visitors should not be allowed to visit the unit The unit functions normally, with a sign on the door alerting visitors to the presence of radioactive material. Visitors can spend time with the client but should wear a surgical mask A surgical mask does not provide protection against radiation.
The nurse is caring for a client who underwent external beam radiation for breast cancer. The client complains of skin irritation at the site. Which of the following recommendations is appropriate for the nurse to make? Expose the site to air and natural sunlight to help reduce irritation Use powder to protect the area from moisture Wash the site daily with warm water and pat dry Cover the site with gauze and tape to prevent rubbing
Answer ✅Wash the site daily with warm water and pat dry Irradiated skin is extremely vulnerable. The radiation beam damages skin and can cause temporary or permanent changes. The nurse should teach the client to wash the area with warm water daily, using a mild soap if desired, and to thoroughly rinse the area so no residue remains, and pat dry with a soft cloth. Do not rub. Expose the site to air and natural sunlight to help reduce irritation Irradiated skin should not be exposed to sunlight, because sunlight is a form of radiation and this will further damage the area. Use powder to protect the area from moisture Powder should not be applied to irradiated skin. Instead, the client can use only radiologist-approved lotion. Cover the site with gauze and tape to prevent rubbing Tape irritates the skin and should not be used on an irradiated area.
