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Difficulty: Very hardReduction of Risk Potential

A nurse enters the room of a client receiving internal radiation therapy (brachytherapy) for cervical cancer. The nurse discovers that the intracavitary radioactive applicator has accidentally dislodged and is resting on the client's bed linens. To safely reduce the risk of harmful radiation exposure, arrange the following nursing actions in the correct priority sequence.

  1. 1Instruct the client to remain completely still and direct all visitors to exit the room.
  2. 2Put on a lead-lined apron to ensure personal shielding.
  3. 3Grasp the dislodged radioactive implant using long-handled forceps.
  4. 4Place the radioactive implant into the lead-lined containment pig located in the room.
  5. 5Notify the radiation safety officer and the healthcare provider of the dislodgement.

Answer

The correct sequence is: 1) Clear the room and keep the client still, 2) Don a lead apron, 3) Use long-handled forceps, 4) Place the implant in a lead-lined container, and 5) Notify the radiation safety officer and provider.
The correct sequence prioritizes the ALARA (As Low As Reasonably Achievable) radiation safety principles: Time, Distance, and Shielding. The immediate priority is to use distance to protect unshielded visitors by evacuating them and keeping the client still to prevent the source from falling. Next, the nurse must apply personal shielding (lead apron) before approaching the hazard. To minimize exposure time and maintain distance, the nurse uses long-handled forceps to retrieve the source and immediately secures it in a lead-lined container. Only after the acute physical hazard is contained should the nurse leave the bedside to notify the radiation safety officer and provider.

Step-by-Step Solution

1
Instruct the client to remain completely still and direct all visitors to exit the room.
Unshielded individuals are removed from the radiation field.
Distance is the most effective immediate protection against radiation exposure. Keeping the client still prevents the source from falling to the floor, which would widen the contamination area.
2
Put on a lead-lined apron to ensure personal shielding.
The nurse's core organs are protected from gamma radiation.
ALARA principles dictate that personnel must utilize appropriate shielding before closely approaching an active radiation source.
3
Grasp the dislodged radioactive implant using long-handled forceps.
The radioactive source is retrieved safely.
Radioactive materials must never be touched directly with hands. Forceps provide necessary distance between the radiation source and the nurse's hands.
4
Place the radioactive implant into the lead-lined containment pig located in the room.
The radiation source is fully shielded and contained.
Placing the source in the designated lead pig immediately terminates the acute radiation exposure hazard in the environment.
5
Notify the radiation safety officer and the healthcare provider of the dislodgement.
Specialized personnel are alerted to the incident.
Once the immediate danger is neutralized, specialists must evaluate the client for potential tissue damage, sweep the room for residual radiation, and adjust the cancer treatment plan.

Key Concept

ALARA Principles and Internal Radiation Safety Protocols
Estimated Time:1m 30s
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Topics

Reduction of Risk Potential

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