Which action should be included in the nursing care for a client with cervical cancer who has an internal imp… - NHM MP Staff Nurse-2022

NHM MP Staff Nurse-2022

Medical & Surgical Nursing

Medium

Appeared in: NHM MP Staff Nurse-2022

Explanation

The primary goal in caring for a patient with an internal radiation implant is to maintain its precise position and ensure safety.
A low-residue (low-fiber) diet is prescribed to decrease the frequency and volume of bowel movements.
Preventing defecation reduces the risk of straining and applying pressure on the cervix, which could dislodge the radioactive applicator.
This ensures the radiation is delivered accurately to the tumor while minimizing exposure to adjacent healthy organs like the rectum.

Option A: An indwelling urinary (Foley) catheter is inserted before the procedure to keep the bladder continuously empty. This prevents bladder distention, which could displace the implant or expose the bladder wall to high doses of radiation. Therefore, offering a bedpan for urination is not required.
Option B: Perineal care, especially any procedure that involves flushing or deep cleaning, is contraindicated while the implant is in place. Such actions carry a high risk of accidentally moving or dislodging the applicator and the vaginal packing that secures it.
Option C: This action violates the fundamental radiation safety principle of minimizing time spent near the radioactive source (ALARA). Nurses should cluster care and work efficiently to limit their exposure. The applicator's position is confirmed via imaging after placement, not by frequent manual checks.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing management of a patient undergoing internal radiation therapy (brachytherapy) for cervical cancer to guide bedside assessment, documentation, and the next nursing action.
The nurse's role in caring for a patient with brachytherapy is a balance between providing comfort and ensuring patient and staff safety.
Key responsibilities include managing side effects, preventing implant dislodgement, and strictly adhering to radiation safety protocols (time, distance, shielding).
Patient education is vital. The patient must understand the need for strict bed rest and the rationale behind dietary and activity restrictions.

How to Approach the Question

First, identify the core clinical situation: a patient with an internal radiation implant for cervical cancer.
Recall the two primary nursing priorities for this situation: 1) ensuring the implant remains in the correct position, and 2) protecting staff and visitors from radiation exposure (ALARA principle).
Evaluate each option against these two priorities.
Option A (bedpan): This relates to implant position. An empty bladder is needed, which is achieved with a catheter, making this option incorrect.
Option B (perineal care): This relates to implant position. It risks dislodgement, so it's incorrect.
Option C (hourly check): This relates to radiation safety. It violates the 'minimize time' rule, so it's incorrect.

Concept Tested & Keywords

Concept Tested: Nursing management of a patient undergoing internal radiation therapy (brachytherapy) for cervical cancer.
Stem keywords: nursing care, cervical cancer, internal implant
Lead-in keywords: action, included

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