The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require immediate intervention?

The UAP stands by the patient's bed for 60 minutes talking with the patient.

The UAP gives the patient a saline mouthwash to use for oral care.

The UAP places the patient's bedding in the laundry container inside the clients room.

The UAP flushes the toilet twice after emptying the patient's bedpan.

Answer and Explanation

The Correct Answer is A

A) The UAP stands by the patient's bed for 60 minutes talking with the patient:
This action requires immediate intervention because of the potential radiation exposure to the UAP. A temporary radioactive cervical implant involves placing a radioactive source in or near the patient's cervix. This implant emits radiation, and safety precautions are essential to limit exposure to others, including healthcare workers. Prolonged close contact, such as standing by the patient's bed for 60 minutes, increases the risk of radiation exposure to the UAP.

B) The UAP gives the patient a saline mouthwash to use for oral care:
There are no specific contraindications to using a saline mouthwash for oral care in patients with a radioactive implant. Saline mouthwash is commonly recommended for patients undergoing radiation therapy to soothe the mouth and prevent dryness or irritation. As long as the UAP is following standard infection control and safety precautions.

C) The UAP places the patient's bedding in the laundry container inside the client's room:
Bedding and linens from a patient with a radioactive implant can usually be handled and disposed of according to hospital guidelines for radioactive waste. Often, these linens are not considered to pose a significant radiation hazard after removal from the patient’s immediate area, especially if the patient is not emitting radiation outside the prescribed safety guidelines.

D) The UAP flushes the toilet twice after emptying the patient's bedpan:
After the patient has a radioactive implant, any bodily waste (urine, stool) can potentially contain small amounts of radiation. Flushing the toilet twice helps to ensure that any radioactive materials are effectively cleared. However, the UAP should be instructed to wear gloves and take other precautions to prevent contamination while handling the bedpan and ensuring proper disposal of waste.

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Correct Answer is D

Explanation

A) Inability to void:
While urinary retention or difficulties with voiding can occur in ALS patients due to weakened muscles affecting the bladder, it is not the most immediate or life-threatening symptom that requires urgent attention. ALS primarily affects motor neurons and the voluntary muscles, and while autonomic dysfunction can lead to bladder or bowel issues, these are typically not the first concern in the acute phase of ALS unless they are severe.

B) Unable to eat without thickening meals:
Dysphagia (difficulty swallowing) is a common symptom in ALS, especially as the disease progresses and affects the muscles of the throat. While this symptom is important to address, it is manageable with interventions like speech therapy, modified diets, and thickened liquids

C) Loss of function in the lower extremity:
Loss of function in the lower extremities is a hallmark symptom of ALS as the disease progresses, but it is not an acute or life-threatening situation on its own. ALS leads to gradual muscle weakness and atrophy, particularly affecting voluntary motor functions.

D) Difficulty breathing:
As ALS progresses, respiratory muscles, including the diaphragm and intercostal muscles, weaken, which can lead to respiratory failure. The inability to breathe adequately can be life-threatening and may require interventions like mechanical ventilation, non-invasive positive pressure ventilation (BiPAP), or even a tracheostomy.

A. Jaundice B. Hyperglycemia C. Hypertension D. Orthostatic hypotension

Correct Answer is D

Explanation

A) Jaundice:
Carbidopa-levodopa works by increasing dopamine levels in the brain to help alleviate symptoms of Parkinson's disease, but it is not typically associated with liver dysfunction that would lead to jaundice. If jaundice were to occur, it could indicate liver problems, which would need to be evaluated further, but this is not a typical side effect of Sinemet.

B) Hyperglycemia:
Sinemet primarily affects dopamine levels in the brain and does not have a direct impact on blood sugar regulation. However, long-term use of certain medications, especially corticosteroids or other specific treatments, can affect glucose levels, but carbidopa-levodopa is not typically linked to hyperglycemia.

C) Hypertension:

Carbidopa-levodopa may lead to fluctuations in blood pressure, including lowering blood pressure, especially when the patient is changing positions. However, hypertension is not a typical response to this medication. Instead, patients may experience orthostatic hypotension, which is more common with carbidopa-levodopa.

D) Orthostatic hypotension:
Orthostatic hypotension is a well-recognized and common side effect of carbidopa-levodopa. This occurs because Sinemet affects the autonomic nervous system, which can cause a decrease in blood pressure when moving from a sitting or lying position to standing. Patients on carbidopa-levodopa should be advised to rise slowly to minimize the risk of dizziness or fainting due to orthostatic hypotension.

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The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require immediate intervention?

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