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Difficulty: HardEmergency Response and Hazardous Materials

A practical nurse (PN) is assigned to the exterior triage area of a hospital following an explosion at a local radiological facility. An ambulatory client arrives covered in a fine, unknown dust and is holding a visibly deformed right wrist. The client's airway is patent, and breathing is unlabored. Which of the following is the priority action for the PN to take?

  1. Direct the client to the designated external decontamination zone for immediate showering.Answer
  2. B
    Remove the client's dust-covered outer clothing and then don personal protective equipment.
  3. C
    Perform a comprehensive initial physical assessment to identify any internal blast injuries.
  4. D
    Assess the client's pain level and request a prescription for analgesic medication.

Answer

Direct the client to the designated external decontamination zone for immediate showering.
The correct action prioritizes facility safety and hazard removal. In any hazardous materials or radiological incident, clients who have stable airways and breathing must undergo immediate external decontamination. Directing the client to an external shower stops ongoing exposure to the radioactive dust and prevents secondary contamination of the healthcare staff and the interior hospital environment.

Step-by-Step Solution

1
Evaluate the client's immediate life-threatening status (ABCs).
The client has a patent airway and unlabored breathing, meaning they are stable enough for decontamination.
Basic life support always precedes decontamination, but since the ABCs are stable, the focus shifts to hazard containment.
2
Identify the primary threat to the client, staff, and facility.
The unknown radiological dust poses a severe contamination and radiation exposure risk.
Bringing a contaminated client inside or delaying removal of the agent causes secondary exposure.
3
Determine the most appropriate initial nursing intervention.
The client is directed to the external decontamination zone.
External wet decontamination removes the hazardous material, protecting the client from further absorption and securing the hospital environment.

Key Concept

Radiological Emergency Decontamination Protocol
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Topics

Emergency Response and Hazardous Materials

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