A nurse is teaching a client who has a new colostomy about how to control odors and flatus.
Which of the following instructions should the nurse include?

Choice A rationale

A dosimeter is used to measure the amount of radiation exposure for the healthcare professional, not the client. It is a personal radiation-monitoring device that provides a record of an individual's accumulated dose of ionizing radiation. Attaching a dosimeter to the client's gown is an inappropriate intervention as the client is the source of the radiation, and the dosimeter is designed to protect the healthcare worker by monitoring their exposure.

Choice B rationale

Brachytherapy involves placing a radioactive source close to the tumor. To minimize the radiation exposure of others, a safe distance is maintained. A distance of at least 1 meter (3.3 feet) from the source of radiation is a standard safety measure for visitors and healthcare staff. This inverse square law principle of radiation safety dictates that intensity decreases with the square of the distance from the source, so increasing distance significantly reduces exposure.

Choice C rationale

When a client is undergoing brachytherapy, it is essential to limit the amount of time visitors spend in close proximity. The typical time limit for visitors is 30 minutes per day, not 2 hours. This is a crucial radiation safety measure that adheres to the principle of "Time, Distance, and Shielding.”. Limiting the time of exposure directly reduces the total radiation dose received by the visitor, thereby minimizing potential harm from the radiation source.

Choice D rationale

For a client undergoing brachytherapy, there is a risk that the radioactive implant could be dislodged and expelled from the body. Therefore, straining the client's urine is a critical intervention. This allows the nurse to inspect for and retrieve the implant if it has been inadvertently expelled, ensuring it is not lost and that appropriate safety protocols for handling radioactive materials are followed. This also prevents potential radiation exposure to others. *.

Choice A rationale

Verifying the clarity and color of the eye drops is a critical safety step to ensure the medication has not been compromised. Eye drops should be clear and colorless unless specified otherwise. Any discoloration or particulate matter indicates that the solution may be contaminated or expired and should not be administered, preventing potential harm or infection to the client.

Choice B rationale

Pulling the lower lid down creates a small pocket, or conjunctival sac, which is the proper site for medication administration. This technique prevents the eye drops from immediately flowing out of the eye, allowing for maximum absorption of the medication. It also protects the cornea from direct injury by the applicator, which can be sensitive and easily scratched.

Choice C rationale

Applying gentle pressure to the punctum, the small opening in the corner of the eye, for 30 to 60 seconds after instillation prevents systemic absorption of the medication. This is particularly important for drugs like timolol, a beta-blocker, as systemic absorption can lead to adverse effects on the heart and lungs, such as bradycardia and bronchospasm.

Choice D rationale

Tilting the client's head backward facilitates proper administration by allowing gravity to assist in directing the eye drop into the conjunctival sac. This position also helps to prevent the drop from immediately rolling out of the eye or onto the client's cheek, ensuring the medication is retained in the correct location for therapeutic effect.

Choice E rationale

Administering the prescribed number of drops directly into the conjunctival sac ensures the client receives the correct dosage. The nurse should avoid touching the tip of the dropper to the client's eye or eyelashes to prevent cross-contamination of the bottle. This step is essential for both the therapeutic efficacy and safety of the medication administration. *.