The nurse is caring for a patient with cervical cancer. The nurse notes that the cervical implant has become dislodged. Which of the following actions should the nurse take first?

Appeared in: GMCH Chandigarh - 2019

Explanation

The immediate priority when a sealed radiation source is dislodged is to contain it to prevent exposure to the patient and staff.
Using long-handled forceps maximizes the distance from the source, a key principle of radiation safety.
Placing the implant in a lead-lined container provides immediate shielding, the second key principle of radiation safety.
This action is the fastest and safest way to manage the immediate hazard before notifying other departments.

Option A: Staying with the patient and contacting radiology is a necessary step, but it is not the first action. Leaving the radioactive source exposed while making a phone call unnecessarily prolongs the exposure time for both the nurse and the patient.
Option B: This is an unsafe action. A blanket offers no shielding from radiation. Wrapping the implant, even with gloves, risks close contact and contamination of the blanket, increasing the exposure hazard.
Option C: A dosimeter is a device worn by staff to monitor their cumulative radiation exposure over time. It is not an emergency intervention tool and does not measure patient exposure or mitigate the immediate danger from the dislodged source.

Clinical Relevance

Nursing practice connection: Use the key finding related to Emergency management of a dislodged brachytherapy implant to guide bedside assessment, documentation, and the next nursing action.
Nurses caring for patients with brachytherapy must be knowledgeable about emergency procedures for dislodged implants.
A radiation safety kit, including long-handled forceps and a lead-lined container, must be readily available in the room of any patient with an intracavitary implant.
Strict adherence to the principles of Time, Distance, and Shielding is crucial to ensure the safety of both patients and healthcare providers.

How to Approach the Question

First, identify the immediate hazard in the clinical scenario. Here, it is a dislodged radioactive implant, which poses an active radiation risk.
Recall the fundamental principles of radiation safety: Time, Distance, and Shielding.
Evaluate each option based on which action best applies these principles to resolve the immediate hazard.
Option A (calling radiology) delays containment, increasing exposure time.
Option B (using a blanket) is unsafe handling and provides no shielding.
Option C (using a dosimeter) is an assessment tool, not an intervention.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 pp. 75-77, 76-78

Practise the full GMCH Chandigarh - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.