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Difficulty: Very hardHandling Hazardous and Infectious Materials

A client is admitted to a private room for treatment with a high dose of unsealed radioactive iodine (I-131) for thyroid carcinoma. Which sequence of nursing interventions best demonstrates safe handling of this radioactive biological hazard?

  1. Maximize distance by standing at least 6 feet (1.8 meters) away when speaking with the client, instruct the client to flush the toilet twice after voiding, and retain all trash and linens in the client's room.Answer
  2. B
    Wear a standard 0.5 mm lead apron when providing direct physical care, limit nursing contact to 30 minutes per shift, and collect all client urine in a designated shielded container.
  3. C
    Implement standard and airborne precautions, ensure all staff entering the room wear a radiation dosimeter badge, and strictly prohibit any visitors under the age of 18.
  4. D
    Double-glove before touching any surface in the room, encourage the client to use disposable plates and utensils, and immediately transport all soiled linens to the hazardous waste utility room.

Answer

Maximize distance (at least 6 feet), flush the toilet twice, and retain all trash and linens in the room.
Unsealed I-131 makes all client bodily fluids radioactive. Maintaining a distance of at least 6 feet utilizes the inverse-square law to significantly reduce radiation exposure. Since I-131 is primarily excreted via the kidneys, flushing the toilet twice safely dilutes and removes the highly radioactive urine from the immediate environment. Finally, all trash and linens must be retained in the room because they may be contaminated with radioactive sweat or saliva; they cannot be removed until the Radiation Safety Officer determines the radioactivity has decayed to a safe level.

Step-by-Step Solution

1
Identify the specific nature of the hazard.
The client is receiving unsealed I-131, meaning all bodily fluids (urine, sweat, saliva) are systemically radioactive.
Different radiation types (sealed vs. unsealed) require entirely different management protocols.
2
Apply the ALARA (As Low As Reasonably Achievable) principles for radiation safety.
Maximize distance (at least 6 feet) and minimize time.
Distance is the most effective protection against the high-energy gamma rays emitted by I-131, following the inverse-square law.
3
Determine the safe disposal method for highly radioactive bodily fluids.
Instruct the client to flush the toilet two to three times after voiding.
Urine contains the highest concentration of excreted I-131. Rapid dilution and flushing removes the hazard, whereas storing it in a container creates a continuous radiation source in the room.
4
Determine the protocol for potentially contaminated environmental items.
Retain all trash, linens, and food trays inside the client's room.
These items may be contaminated with radioactive sweat or saliva. Moving them outside the room exposes other staff and patients; they must stay in the room until surveyed by the Radiation Safety Officer (RSO).

Key Concept

Management of unsealed radioactive isotopes involves protecting against contaminated bodily fluids, using distance to minimize gamma exposure, and preventing environmental contamination by keeping all items in the room until cleared by an RSO.
Estimated Time:1m 30s
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Topics

Handling Hazardous and Infectious Materials

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