Gail, age 49, is a married mother of four. During her recent gynecological exam she was found to have a
Class IV pap smear resulting in the diagnosis of cervical cancer. She is admitted to the hospital for an
internal radiation implant (brachytherapy) by way of an applicator placed into the vagina.
● Gail asks why she has to be in a private room. What is your response?
○ Because she is radioactive (safety reasons)
○ Low dose brachytherapy (bed ridden and in the hospital)
● Gail has a foley catheter inserted prior to the intra-vaginal applicator insertion. Why?
○ If bed ridden, cannot go to the bathroom à the catheter cannot be removed
○ Painful if patient moves
○ Still radioactive
● Gail is placed on anti-diarrheal medication a low fiber diet. Why?
○ Stool can also be radioactive (do not want it everywhere)
● Gail asks if you could help her shower in the bathroom. What is your response?
○ Cannot take her to the shower because the foley catheter is inserted (so she cannot move)
○ We have to be at least 6 feet away from the patient and can only be exposed for 30
minutes
○ Call a specialized nurse in regards to this specific patient
● What precautions should you as the nurse take while caring for Gail?
○ Make sure to be 6 feet away from the patient
○ The dosimeter to measure radiation amount (switch nurse when almost the same amount)
■ If pregnant, do not take care of this patient due to risks
○ Proper PPE
● What nursing diagnoses would be appropriate for Gail at this time?
○ Fatigue r/t continuous bedrest and foley catheter insertion
○ Risk for isolation r/t internal radiation
Care of the Patient Receiving Chemotherapy for Breast Cancer
Grace is a married 36-year old woman with 2 daughters, ages 5 and 8. She works part-time as a sales
clerk. Grace has never smoked, and drinks socially. She has a past medical history of plastic surgery for