A patient is receiving internal radiation therapy for a gynecological malignancy. She expresses feelings of isolation in her private room. What intervention would be best on the part of the nurse?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019

Explanation

Patients undergoing internal radiation (brachytherapy) often feel isolated due to being placed in a private room with restricted contact.
The most therapeutic nursing intervention is to address the patient's feelings by explaining the reason for the precautions.
Educating the patient helps them understand that isolation is a necessary safety measure to protect others, not a form of personal rejection.
This knowledge can reduce anxiety, increase the patient's sense of control, and improve their ability to cope with the treatment.

Option A: This action violates the radiation safety principle of limiting exposure time for visitors. Prolonged stays would expose family members to unsafe levels of radiation.
Option B: This action is strictly contraindicated. A patient with a radioactive implant must be in a private room to prevent radiation exposure to other patients, staff, and visitors.
Option D: This action violates the radiation safety principle of limiting exposure time for healthcare workers (ALARA principle). Nurses must minimize their time in the room to avoid cumulative radiation exposure.

Clinical Relevance

Nursing practice connection: Use the key finding related to Psychosocial support and safety for patients undergoing internal radiation therapy (brachytherapy) to guide bedside assessment, documentation, and the next nursing action.
The nurse's role in brachytherapy is a balance between providing essential physical care, ensuring safety for everyone, and offering crucial psychosocial support.
Feelings of isolation and depression are common in these patients; addressing them through education and facilitating safe communication (e.g., phone calls) is a key nursing responsibility.
What if the patient wants to leave the room? The nurse must calmly re-explain the safety reasons, emphasize the temporary nature of the restrictions, notify the provider and radiation safety officer immediately, and ensure the patient does not leave, as this would be a serious safety breach.

How to Approach the Question

First, identify the core problem: the patient feels isolated.
Next, recognize the clinical context: the patient is receiving internal radiation, which has strict safety protocols.
Evaluate each option based on the principles of radiation safety: Time, Distance, and Shielding.
Eliminate any options that violate these safety principles (A, B, and D all violate one or more).
The remaining option (C) addresses the patient's psychosocial needs (feelings of isolation) in a way that is safe and therapeutic, by providing education and understanding.

Concept Tested & Keywords

Concept Tested: Psychosocial support and safety for patients undergoing internal radiation therapy (brachytherapy).
Stem keywords: internal radiation therapy, gynecological malignancy, feelings of isolation, private room
Lead-in keywords: best intervention
Clinical cues: The patient's expression of 'feelings of isolation' is the primary psychosocial problem to be addressed within the constraints of radiation safety.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 75-77

E6 Nursing Fundamentals Potter Perry 12e Part 2 p. 236-238

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