Rationale

circulate through the patient's body and cannot contaminate urine, blood, feces, or other secretions.

Unsealed sources: colloid suspensions that come in direct contact with body tissues, are administered IV or PO or instilled into a body cavity. The isotope may be excreted into any body fluid.

Dispose of all wastes according to hospital protocol if the patient has an unsealed source.

Teach the patient to flush the toilet several times after voiding if appropriate.

If the patient has a discharge, discard the linen according to hospital standards.

Plan care so as to spend a minimal amount of time in the room.

Do not spend more than 30 min in the room per shift.

Strategies to maximize time:

• Fix food trays outside the room.

• Work as quickly as possible.

• Take a prepared bed roll into the room for linen changes.

• Do not care for more than one patient per shift with radiation implants.

• Reassign pregnant staff to other assignments.

• Notify the patient that young children and pregnant family or friends should not visit until after the implant is removed.

Use distance between the nurse and the patient during caregiving activities (note: social isolation may result):

• If patient can be out of bed, have her sit as far as possible from the bed during linen changes.

• Provide care standing at the patient's shoulder, where exposure is low; this technique also uses the patient's body as a shield.

Encourage the woman to limit body movements while the source is in place. Keep all personal items within easy reach to limit stretching or straining. Limit lower extremity exercises. Provide diversionary activity such as reading, television, radio, tapes.

Wear a radiation monitoring device at all times when in the room.

Mark the room with radiation safety signs.

Decrease the risk of radiation exposure to those other than the patient.

Limits radiation exposure

Limits radiation exposure

Decreases the risk of dislodging the implant

Records exposure

Limits the risk of accidental expo-

Keep long-handled forceps and a lead-lined container on the unit at all times.

Request that radiation safety monitor all unit procedures for compliance.

If the implant is accidentally dislodged, use the forceps to place it in the container and notify radiation safety and the physician immediately Limits the risk of accidental exposure

Pharmacologic Highlights

Medication or Drug Class

Dosage

Description

Rationale

Doxorubicin; cisplantin;

Given in combination

Antineoplastic

Response rate of 15%

carboplatin; ifosfamide;

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