What precautions do we need to take?

[nsgnva]

I have a general question for all you oncology nurses out there. We have a resident (patient) in our LTC/SNF facility who is receiving radiation and chemo (temodar) for glioblastoma. It's been a very long time since I worked the oncology unit at my local hospital, but I recall there were sometimes special precautions we had to take. I understand the precautions to protect the resident, because of the potential for white cell destruction and higher risk of her getting an infection.But aren't there precautions we are supposed to take to also protect the staff?? Seems I recall something about some chemo drugs excreting in the patients urine? If someone would so kindly lead me in the general direction for information, I'd greatly appreciate it.

[iluvivt, BSN, RN]

Handle any body excreta using chemotherapy precautions for at least 48 hours after chemotherapy administration. . Use Chemo gloves and any contaminated linen needs to be bagged in water soluable plastic bag indicating chemo exposure. You only have to limit distance and time if the patient has a radium implant......if just receiving radiation ,there are no special precautions to protect the nurse or worker.

[NurseLacy]

For that regimen, there are no special precautions. Universal precautions will be the most effective.

Do make sure the patient is given anti-nausea meds 1 hour prior to Temodar and XRT. Both are highly emetogenic and will cause the patient to be very sick. And patient will only take Temodar on the days they receive radiation (Mon-Fri).

I am a current oncology nurse and a previous radiation oncology nurse.

[aeberstein]

Actually you should ALWAYS take special precautions with a patient on Temodar. Temodar is considered a chemotherapeutic agent even though it is taken orally, what this means for you is that chemo precautions must be in place for the duration of the patients stay or 48 hours after his Temodar is discontinued. All of the patients fluids, stool, urine, emesis are considered hazardous - nitrile gloves, gown, double flushing should all be in effect. These are the OSHA and ONS standards nurses who practice without putting your patients on these precautions are practicing outside of the recommendations.