Nursing Management in Radiation Therapy

The patient receiving radiation therapy and the family often have questions and concerns about its safety. To answer questions and allay fears about the effects of radiation on others, on the tumor, and on the patient’s normal tissues and organs, the nurse can explain the procedure for delivering radiation and describe the equipment, the duration of the procedure (often minutes only), the possible need for immobilizing the patient during the procedure, and the absence of new sensations, including pain, during the procedure. If a radioactive implant is used, the nurse informs the patient and family about the restrictions placed on visitors
and health care personnel and other radiation precautions. Patients also need to understand their own role before, during, and after the procedure. See Chapter 47 for further discussion of radiation treatment for gynecologic cancers.

PROTECTING THE SKIN AND ORAL MUCOSA
The nurse assesses the patient’s skin, nutritional status, and general feeling of well-being. The skin and oral mucosa are assessed frequently for changes (particularly if radiation therapy is directed to these areas). The skin is protected from irritation, and the patient is instructed to avoid using ointments, lotions, or powders
on the area. Gentle oral hygiene is essential to remove debris, prevent irritation, and promote healing. If systemic symptoms, such as weakness  and fatigue, occur, the patient may need assistance with activities of daily living and personal hygiene. Additionally, the nurse offers reassurance by explaining that these symptoms are a result of the treatment and do not represent deterioration or progression of the disease.

PROTECTING THE CAREGIVERS
When a patient has a radioactive implant in place, nurses and other health care providers need to protect themselves as well as the patient from the effects of radiation. Specific instructions are usually provided by the radiation safety officer from the x-ray department. The instructions identify the maximum time that can
be spent safely in the patient’s room, the shielding equipment to be used, and special precautions and actions to be taken if the implant is dislodged. The nurse should explain the rationale for these precautions to keep the patient from feeling unduly isolated. (Medical and Surgical Nursing; Brunner & Suddarth10th Edition)

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