NCLEX Memory Hints: Radiation

NCLEX Memory Hints: Radiation

Radiation therapy may external or internal depending on the type of cancer that is being treated. Medical professionals need to use radiation precautions when unsealed radiation is used.

External radiation

External radiation is also known as teletherapy. It is done Monday through Friday for 15-30 minutes a day at a center. After 5 days, fatigue is a major side effect. Patients need the two-day period to rest and strengthen their immune system. The patient will not be radioactive after a treatment. Tissue damage to the target area may be seen. Radiation pneumonia may develop with chest radiation. 

Internal radiation 

Internal radiation is also known as brachytherapy. The radiation dose is concentrated in the tumor and may be temporary or a permanent implant. It may also be sealed or unsealed. As an example, prostate cancer may be treated with temporary or permanent internal radiation. 

Temporary (in prostate cancer) 

Temporary-hollow needles or catheters filled with radioactive material are placed into the prostate gland for 5-15 minutes and then the material is removed. The process is repeated 2-3 times over several days. 

Permanent (in prostate cancer) 

Anywhere from 40-100 seeds are implanted in the prostate gland. After a couple of months, no radiation remains. In prostate cancer, it is used when the cancer is not very aggressive. 

Sealed radiation 

Sealed radiation emits radiation, but excretions are not affected, and radiation precautions are not needed. Examples include prostate and breast. 

Unsealed radiation 

Unsealed radiation emits radiation in the excretions and radiation precautions are needed. Examples include oral seeds, implants, any injections, bladder instillation, and Iodine-131. 

An internal, temporary implant may be used for cervical and endometrial (uterine) cancer. A complication is a fistula between the vagina and bladder or rectum. 

Bladder instillation (intravesical) is used for bladder cancer. Once instilled, the dwell time is 2 hours with shifting every 20 minutes. After being eliminated in the toilet, household bleach is used for disinfection for up to six hours.         

Radiation precautions 

Radiation precautions are used for unsealed radiation. It is like chemotherapy precautions with some modifications. 

Time: Limited with the patient and should be a maximum of 30 minutes in 8 hours. 

Distance: Minimum distance of 6 feet is maintained when possible. 

Shielding: Needed when longer time is spent or closer contact with the patient. Because of the design of the shield, the nurse must back away to avoid radiation exposure to the back.

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