Radiation Therapy

• Types of Radiation Therapy

  Brachytherapy - Internal Radiation Therapy
• Types of Radiation Therapy

  Teletherapy - External Radiation Therapy
• Types of Internal Radiation Therapy

  Sealed Source - If half - life of radioisotope is long (in a bead, seed, needle, ribbon, catheter)
• Types of Internal Radiation Therapy

  Sealed source - Body secretions are NOT contaminated
• Types of Internal Radiation Therapy

  Unsealed Source - If half- life of radioisotope is short (Oral, IV, installation to cavity)
• Types of Internal Radiation Therapy

  Unsealed Source - Radioactive Iodine I131 for thyroid cancer
• Types of Internal Radiation Therapy

  Unsealed Source - Body secretions are radiation contaminated
• Types of Internal Radiation Therapy

  Unsealed Source - Flush toilet twice and rinse sink well after toothbrushing
• Nursing Management of Internal Radiation Therapy

  There is a need to implement isolation for a client undergoing internal radiation therapy
• Nursing Management of Internal Radiation Therapy

  The client is encouraged to turn to sides at intervals
• Nursing Management of Internal Radiation Therapy

  Enema is done before procedure, low fiber diet is provided during the therapy to prevent defecation during treatment, thereby preventing dislodgment of the radioisotope.
• Nursing Management of Internal Radiation Therapy

  Complete bedrest is necessary to prevent dislodgement of the radioisotope
• Nursing Management of Internal Radiation Therapy

  Long forceps must be readily available, to pick up radioisotope, if it is dislodged.
• Nursing Management of Internal Radiation Therapy

  Place dislodged radioisotope in a lead container
• Principles of Radiation Protection

  Distance: Maintain a distance of at least 6 feet from the patient when not performing nursing procedures
• Principles of Radiation Protection

  Time including visitation: Minimize contact with patient. Limit contact with patient for 5 minutes each time, a total of 30 minutes per shift
• Principles of Radiation Protection

  Shielding: Wear lead shield when entering patient's room
• Principles of Radiation Protection

  Dosimeter badge - measures radiation exposure; individualized, presented to RSO; 1 nurse:1 patient only, 1 patient:multiple nurse is allowed
• Principles of Radiation Protection

  Pregnant nurses and children should NOT be assigned to care for patients undergoing internal radiation therapy to prevent congenital defects
• Principles of Radiation Protection

  Use disposable eating utensils for the patient with internal radiation therapy to prevents radiation contamination of other people
• Radiation Therapy

  Teletherapy is administered through X-ray or high-energy machine; Electromagnetic Radiation (radioisotope) passes through beam and light
• Teletherapy

  Reassure patient that the procedure is painless; each treatment lasts for few minutes only
• Teletherapy

  Inform patient that there is NO residual radioactivity; ADLs may be resumed immediately after the treatment
• Teletherapy

  There is NO need for isolation of the patient after the procedure
• Teletherapy Adverse EffectsA/E: Stomatitis - ulceration of oral mucous membraneN/I:

  • Administer analgesics before meals
  • Bland diet
  • AVOID Smoking/Alcohol
  • Good oral hygiene/Saline rinses every 2 hours
  • Sugarless lemon drops or mint to increase salivation
• Teletherapy Adverse Effects

  A/E: Xerostomia - excessive dryness of the mouth

  N/I: Artificial saliva
• Teletherapy Skin Care

  • First sign of adverse effects: Erythema
  • Wash are with WATER, if with soap: mild ONLY
  • Clothing: Loose cotton
  • AVOID CLAMP; allowed are unperfumed lotion and cornstarch
  • ACOID direct sunlight, heat or cold
  • DO NOT attempt to remove markings, for 5-6 weeks
  • Swim/Shower: NO chlorine
  • Markings: made up of small permanent tattoo