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BERT:
- background equivelent radiation time
- helps pt understand by comparison the amount of radiation that they will be recieving.
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ALARA
as low as reasonably achievable
- in regards to exposure of radiation to the pt and to staff
- keep radiation exposure and dose to lowest levels possible
- biological response to ionizing radiation is directly proportional to the dose
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ORP
optimization for radiation protection
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ALARA principle:
- TIME: wear film badge, limit amount of time exposed to ionizing radiation
- DISTANCE: recieve less radiation by standing further away from source
- SHIELDING: protective barriers and equiptment
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radiation therapy is:
- use of ionizing radiation to interrupt cellular growth (destroys DNA)
- chosen when the treatment goal is curative as in Hodgkin's disease
- or when tumor cannot be removed surgically
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2 types of ionizing radiation:
- electromagnetic rays (x-rays and gamma rays)
- particles
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radiation cellular effects:
- 20% direct effect: ionizing radiation causes break in DNA, causing cell lysis- cell death
- 80% indirect effect: can also ionize body fluids, esp water in cell, leading to free radicals which cause irreversible damage to DNA
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when are cells most vulnerable to radiation?
- during DNA synthesis and Mitosis
- also tumors that are more well oxygenated are more sensative to radiation.
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radiosensitivity: highly sensative organs:
bone marrow, lymph tissue, GI tract, mucous membranes, gonads
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EXTERNAL RADIATION
- the higher the energy the deeper into the tissues it will penetrate
- kilovoltage: superficial (skin and breast)
- Gamma ray: deeper
- linear accelerators and betatron: high energy to deeper structures without harming the skin
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high energy transfer radiation:
- for hypoxic, radioresistant tumors with neutron beam theraphy, it damages target cells as well as those cells in its pathway.
- like in surgery with the tumor exposed they shoot it
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Acute SE of radiation
- most affected tissues are those that proliferate rapidly, from tx up to 6 months later
- skin
- epi lining of GI
- bone marrow
- fatigue, malaise, h/a, NV
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nursing care of raditaiton:
- keep hydrated
- gentle oral hygiene
- avoid perfumes, deoderants, loose fitting clothess
- apply topical steroids
- diphenhydramine 2.5 mg q 6 hrs
- if oozing (exudate) expose to air for 10-15 mins q 3 times daily
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BRACHYTHERAPY
- high dose radiation to localized areas, relaivly few number of days for treatment
- partial breast radiation
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internal radiation
- implants are more suitable for cancers that tend to remain LOCALIZED, can be combined with external treatment
- systemic (taken orally)
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nursing care of an implant
foley, bed rest, low residue diet, keep clean and dry, no peri care, flush twice
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SE of radiation:
fever, late tissue breakdown, sloughing of tissue, bone necrosis, ulceration, fistulas
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