RADIATION (2)
Regardless of the site treated with radiation therapy, which 2 common side effects occur? 1. Dry mouth 2. Skin changes 3. Diarrhea 4. Fatigue 5. Esophagitis
2. Skin changes 4. Fatigue
What is appropriate teaching for the pt who is having external radiation therapy? 1. "The tx may be painful for the first 5 minutes, but the pain will subside" 2. "You will be radioactive as long as the machine is turned on" 3. "Skin marking made by the radiologist are used to mark areas that be not be irradiated" 4. "Skin over the area being treated may become discolored and irritated"
4. "Skin over the area being treated may become discolored and irritated"
Which statement is most appropriate for a nurse to tell a patient before insertion of the radioactive implant? a. "Nurses will always be available, but they will spend only short periods of time at your bedside." b. "Personal cleanliness is essential, so you will be given a complete bed bath each day." c. "Your diet will be changed to a high-fiber diet to encourage daily bowel movements." d. "Your bed linens will be completely changed each day to minimize radioactive contamination."
ANS: A Generally, it is recommended that the nurse spend no more than 10 minutes at a time in the room of a patient with an implant. Baths and linen changes are not given daily. A low-residue diet is the norm to minimize peristalsis and bowel movements that might dislodge the implant.
The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching? a. The patient swims a mile 3 days a week. b. The patient snacks frequently during the day. c. The patient showers everyday with a mild soap. d. The patient has a history of dental caries with amalgam fillings.
ANS: A The patient is instructed to avoid swimming in salt water or chlorinated pools during the treatment period. The patient does not need to change habits of eating frequently or showering with a mild soap. A history of dental caries will not impact the patient who is scheduled for abdominal radiation.
A patient with uterine cancer is being treated with internal radiation therapy. A primary nursing responsibility is to: a. explain to the patient that she will continue to emit radiation for approximately 1 week after the implant is removed. b. maintain as much distance as possible from the patient while in the room. c. alert family members that they should restrict their visiting to 5 minutes at any one time. d. wear a lead apron when providing direct patient care.
ANS: A explain to the patient that she will continue to emit radiation for approximately 1 week after the implant is removed.
What is the best menu choice for a patient with nausea who is undergoing radiation treatments every other day? a. Bowl of vegetable soup, chopped egg and pickle sandwich on wheat bread, one apple, and 8 oz of orange juice b. Broiled chicken with rice, vanilla yogurt, one-quarter cup of spinach, one-half ripe banana, and 8 oz of grape juice c. Spanish rice, one-half cup of mixed green salad, one-half cup of canned peaches, and 8 oz of Coke d. Spaghetti with tomato sauce, cheddar cheese toast strips, six celery sticks with peanut butter, and 8 oz of whole milk
ANS: B Food choices for a nauseated patient should be mild and easily digested, with no spicy sauces or dark colas
A client in the oncology clinic reports her family is frustrated at her ongoing fatigue 4 months after radiation therapy for breast cancer. What response by the nurse is most appropriate? a. Are you getting adequate rest and sleep each day? b. It is normal to be fatigued even for years afterward. c. This is not normal and Ill let the provider know. d. Try adding more vitamins B and C to your diet.
ANS: B Regardless of the cause, radiation-induced fatigue can be debilitating and may last for months or years after treatment has ended. Rest and adequate nutrition can affect fatigue, but it is most important that the client understands this is normal
A client tells the oncology nurse about an upcoming vacation to the beach to celebrate completing radiation treatments for cancer. What response by the nurse is most appropriate? a. Avoid getting salt water on the radiation site. b. Do not expose the radiation area to direct sunlight. c. Have a wonderful time and enjoy your vacation! d. Remember you should not drink alcohol for a year.
ANS: B The skin overlying the radiation site is extremely sensitive to sunlight after radiation therapy has been completed. The nurse should inform the client to avoid sun exposure to this area. This advice continues for 1 year after treatment has been completed. The other statements are not appropriate.
The nurse is caring for an x-ray technician who wears a badge that is monitored frequently to measure the amount of radiation he has absorbed. The nurse advises the technician that he has the highest risk for developing which type of cancer? a. Bladder cancer b. Leukemia c. Melanoma d. Lung cancer
ANS: B The blood cancer leukemia is associated with radiation exposure. Bladder, melanoma, and lung cancer are associated with other carcinogens
What measures would the home health nurse, designing nursing interventions for a patient receiving external radiation treatments for a malignancy, recommend to protect the patient's skin? a. Applying warm compresses to damaged skin b. Encouraging patient to apply fragrant lotion to skin c. Patting the skin dry after the bath d. Exposing skin to sun for 10 minutes a day
ANS: C Patting the skin dry rather than rubbing is less damaging to the skin. Lotions, sun exposure, and applications of heat or cold are not beneficial.
A nurse discusses the self-care guidelines to minimize the side effects of radiation on the skin. Which actions, to reduce radiation skin reactions, should the nurse explain to the client? SELECT ALL THAT APPLY. 1. Wear loose-fitting, soft clothing over the treated skin. 2. Use a straight edged razor to shave the hair in the treated area. 3. Swim only in swimming pools to avoid stagnant water. 4. Use only skin-care products suggested by the radiation staff. 5. Apply skin products immediately before radiation treatment. 6.Wash treated area gently with lukewarm water and mild soap.
ANSWER: 1, 4, 6 Wearing loose-fitting, soft clothing over the treated skin, using only skin-care products suggested by the radiation staff, and washing the treated area gently with lukewarm water and mild soap are recommended skin-care activities to reduce radiation skin reactions. The use of electric razors for shaving a treated area is recommended. Clients are advised to avoid swimming in chlorinated water and to delay the application of skin-care products within 4 hours of radiation treatment.
The nurse is caring for a patient who is to begin receiving external radiation for a malignant tumor of the neck. While providing patient education, what potential adverse effects should the nurse discuss with the patient? A) Impaired nutritional status B) Cognitive changes C) Diarrhea D) Alopecia
Ans: A Feedback: Alterations in oral mucosa, change and loss of taste, pain, and dysphasia often occur as a result of radiotherapy to the head and neck. The patient is at an increased risk of impaired nutritional status. Radiotherapy does not cause cognitive changes. Diarrhea is not a likely concern for this patient. Radiation only results in alopecia when targeted at the whole brain; radiation of other parts of the body does not lead to hair loss
The clinic nurse is caring for a 42-year-old male oncology patient. He complains of extreme fatigue and weakness after his first week of radiation therapy. Which response by the nurse would best reassure this patient? A) These symptoms usually result from radiation therapy; however, we will continue to monitor your laboratory and x-ray studies. B) These symptoms are part of your disease and are an unfortunately inevitable part of living with cancer. C) Try not to be concerned about these symptoms. Every patient feels this way after having radiation therapy. D) Even though it is uncomfortable, this is a good sign. It means that only the cancer cells are dying.
Ans: A Feedback: Fatigue and weakness result from radiation treatment and usually do not represent deterioration or disease progression. The symptoms associated with radiation therapy usually decrease after therapy ends. The symptoms may concern the patient and should not be belittled. Radiation destroys both cancerous and normal cells.
The nurse is admitting an oncology patient to the unit prior to surgery. The nurse reads in the electronic health record that the patient has just finished radiation therapy. With knowledge of the consequent health risks, the nurse should prioritize assessments related to what health problem? A) Cognitive deficits B) Impaired wound healing C) Cardiac tamponade D) Tumor lysis syndrome
Ans: B Feedback: Combining other treatment methods, such as radiation and chemotherapy, with surgery contributes to postoperative complications, such as infection, impaired wound healing, altered pulmonary or renal function, and the development of deep vein thrombosis.
An oncology nurse is caring for a patient who has developed erythema following radiation therapy What should the nurse instruct the patient to do? A) Periodically apply ice to the area. B) Keep the area cleanly shaven. C) Apply petroleum jelly to the affected area. D) Avoid using soap on the treatment area.
Ans: D Feedback: Care to the affected area must focus on preventing further skin irritation, drying, and damage. Soaps, petroleum ointment, and shaving the area could worsen the erythema. Ice is also contraindicated.
When caring for a client with an internal radiation implant, the nurse should observe which principles? Select all that apply. 1. Limiting the time with the client to 1 hour per shift. 2. Keeping pregnant women out of the client's room. 3. Placing the client in a private room with a private bath. 4. Wearing a lead shield when providing direct client care. 5. Removing the dosimeter film badge when entering the client's room. 6. Allowing individuals younger than 16 years old in the room as long as they are 6 feet away from the client.
Answer: 2, 3, 4 Rationale: The time that the nurse spends in the room of a client with an internal radiation implant is 30 minutes per shift. The client must be placed in a private room with a private bath. Lead shielding can be used to reduce the transmission of radiation. The dosimeter film badge must be worn when in the client's room. Children younger than 16 years of age and pregnant women are not allowed in the client's room.
While giving care to a client with an internal cervical radiation implant, the nurse finds the implant in the bed. The nurse should take which initial action? 1. Call the primary health care provider (PHCP). 2. Reinsert the implant into the vagina. 3. Pick up the implant with gloved hands and flush it down the toilet. 4. Pick up the implant with long-handled forceps and place it in a lead container.
Answer: 4 Rationale: In the event that a radiation source becomes dislodged, the nurse would first encourage the client to lie still until the radioactive source has been placed in a safe, closed container. The nurse would use long-handled forceps to place the source in the lead container that should be in the client's room. The nurse should then call the radiation oncologist and document the event and the actions taken. It is not within the scope of nursing practice to insert a radiation implant.
