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Question

Difficulty: MediumHandling Hazardous and Infectious Materials

A nurse is planning care and safety protocols for a client who is receiving internal radiation therapy (brachytherapy) via a sealed vaginal implant for cervical cancer. Which of the following nursing actions are appropriate to ensure the safe handling of the environment and minimize hazardous exposure? Select all that apply.

  1. Assigning the client to a private room with a private bathroom.Answer
  2. Wearing a personal dosimeter film badge whenever providing direct care in the room.Answer
  3. C
    Removing all trash and soiled bed linens from the room at the end of the shift.
  4. Ensuring a lead-lined container and long-handled forceps are kept in the client's room at all times.Answer
  5. E
    Delegating the unlicensed assistive personnel (UAP) to provide education to the client's family regarding visitor time and distance restrictions.

Answer

The appropriate actions include assigning the client to a private room with a private bathroom, wearing a personal dosimeter film badge when in the room, and ensuring a lead-lined container with long-handled forceps is always kept in the room.
Clients with sealed internal radiation implants pose a direct radiation hazard to others. They must be placed in a private room with a private bathroom to maximize distance and minimize exposure to other patients and staff. A personal dosimeter film badge is required for any staff member entering the room to accurately measure and monitor their cumulative radiation exposure over time. Additionally, a lead-lined container and long-handled forceps must always be present in the room; if the radioactive source accidentally dislodges, the nurse must use the forceps to place the implant into the lead container safely without direct physical contact.

Step-by-Step Solution

1
Identify the primary hazard associated with the scenario.
The client has a sealed internal radiation implant (brachytherapy), which poses a continuous radiation hazard to anyone in close proximity.
Understanding the nature of the hazard dictates the required environmental and personal safety precautions.
2
Evaluate standard radiation safety principles (time, distance, and shielding).
Safety protocols require limiting time near the source, maximizing distance (private room), and using shielding (lead container) alongside exposure monitoring (dosimeter badge).
These principles minimize hazardous exposure to healthcare workers and the public.
3
Analyze each option against radiation safety guidelines and nursing delegation boundaries.
Options involving a private room, dosimeter usage, and emergency lead containers are correct. Options involving the removal of linens or delegating education to a UAP violate safety and scope of practice rules.
Linens must stay in the room to prevent accidental loss of the implant, and teaching is strictly an RN responsibility.

Key Concept

Radiation Safety and Brachytherapy Precautions
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Topics

Handling Hazardous and Infectious Materials

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