A nurse is caring for a client who is receiving brachytherapy for endometrial cancer.
Which of the following actions should the nurse take?
Place the client's soiled bed linens in a biohazard bag outside the client's room.
Wear an isolation gown when caring for the client.
Keep visitors at least 6 feet (1.8 m) away from the client.
Discard the radioactive source in the client's trash can.
The Correct Answer is C
Answer is c. Keep visitors at least 6 feet (1.8 m) away from the client.
a. Place the client's soiled bed linens in a biohazard bag outside the client's room: While it is essential to follow standard precautions for handling potentially contaminated linens, soiled bed linens from a client undergoing brachytherapy do not require special handling in a biohazard bag unless contaminated with blood or bodily fluids. Brachytherapy involves the internal placement of radioactive sources near or within the tumor site, but the risk of contamination from bodily fluids is minimal. Therefore, soiled linens can be managed according to standard facility protocols for handling linens.
b. Wear an isolation gown when caring for the client: This option is incorrect because wearing an isolation gown is not necessary for radiation safety during brachytherapy. Radiation exposure is primarily managed through the use of lead aprons, gloves, and other shielding devices when directly handling radioactive sources or being in close proximity to the client during treatment sessions. Isolation gowns are typically used to prevent the spread of infection and are not specifically designed to shield against radiation exposure.
c. Keep visitors at least 6 feet (1.8 m) away from the client: Correct. This action minimizes radiation exposure to visitors, as brachytherapy involves the internal placement of radioactive material near or within the tumor site. Maintaining a distance of at least 6 feet (1.8 meters) from the client helps reduce the risk of radiation exposure to visitors while allowing them to provide support and companionship to the client. Visitors should also be informed about radiation safety precautions and instructed to limit their time spent near the client during treatment.
d. Discard the radioactive source in the client's trash can: This option is incorrect because radioactive sources used in brachytherapy must be handled and disposed of by trained personnel following established radiation safety protocols. Disposing of radioactive material in a client's regular trash can poses significant risks of exposure to others and is not permitted. Proper disposal procedures for radioactive sources involve packaging them in approved containers and returning them to the facility's radiation safety department for appropriate disposal or recycling.
In summary, the correct answer is c because keeping visitors at least 6 feet (1.8 meters) away from the client helps minimize their radiation exposure during brachytherapy, which involves the internal placement of radioactive material near or within the tumor site. This action aligns with radiation safety principles and helps protect both the client and visitors from unnecessary radiation exposure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Glargine insulin is a long-acting insulin that provides a basal level of insulin over 24 hours. It is suitable for managing blood glucose levels in clients with diabetes mellitus who require a long-acting insulin to maintain glycemic control throughout the day.
Choice B rationale:
NPH insulin is an intermediate-acting insulin that lasts for about 12-16 hours. While it can be used for blood glucose management, it is not the best choice for a client needing long-acting insulin coverage throughout the day.
Choice C rationale:
Insulin aspart is a rapid-acting insulin used to control postprandial glucose levels. It acts quickly to lower blood sugar after meals and is not suitable for long-acting coverage.
Choice D rationale:
Regular insulin, also known as short-acting insulin, is used to control blood glucose levels during meals. It has a faster onset of action compared to long-acting insulins and is not appropriate for managing basal insulin needs over an entire day.
Correct Answer is A
Explanation
A) "My child has some swelling around her eyelids and mouth."
In this scenario, the parent reporting swelling around the toddler's eyelids and mouth after receiving immunizations is the nurse's priority concern. Swelling around the eyes and mouth can be indicative of a possible allergic reaction, such as angioedema or anaphylaxis, which can be a serious and life-threatening condition. Immediate assessment and intervention are needed to address this potential allergic reaction.
The other findings, while important, are not as immediately concerning:
B) A temperature of 100.7 degrees Fahrenheit is a mild fever, which can be expected as a side effect of some vaccines. It may not be the nurse's immediate priority, but it should still be monitored.
C) A toddler's decreased feeding of 2 ounces during her last feeding may be related to her discomfort or fever after immunizations. It's essential to monitor this but not an immediate priority.
D) Crying when touched at the injection site is a common response to immunizations and, while uncomfortable for the child, is not typically a cause for immediate concern. However, it should still be addressed with comfort measures.
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