Pregnant Assignment Room

[souleater11]

Hi everyone,

Can a pregnant client be assign to share a room with a client who is receiving Chemotherapy ?

if your answer is no, can you pls explain your rationale. thanks

thanks

[LeeLeeTheGPN]

It is my understanding that stipulations apply to a patient being treated with radiation, because there is the chance of radiation affecting a fetus. I have not learned that clients receiving chemotherapy must stay away from pregnant clients. Chemotherapy is usually done on an outpatient basis. I have learned that clients receiving chemotherapy are instructed to avoid large crowds, people who are sick, or other things that could cause them to get an opportunistic infection because they are immunocompromised. However, I have not learned about anything that instructs pregnant clients to avoid clients treated with chemotherapy. Anyone is welcome to correct me if I am wrong.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

Although oncology is not my area of expertise, I do work the oncology floor regularly. Our patients who receive chemo as an inpatient report to the infusion department for treatments and then return to their room where there are no special precautions taken. Although I would not recommend a pregnant woman being present during the actual administration of the chemo for the old school reason of "just because", I have to agree with LeeLeeTheGPN. But of course, that holds true for anyone not certified in chemo administration at my hospital.

On the rare occasion that chemo must be done on the floor during the night, ONLY the chemo-certified nurse is allowed in the room during administration times. When administration is complete, the usual activities resume with the care of the patient, visitation, etc.

[Nalon1 RN/EMT-P, BSN, RN]

The pt receiving chemo should not share a room if possible, so no harm to the pregnant pt, but possibly to the chemo pt.

Also as said, chemo is usually an outpatient treatment, so is there something else going on with the pt (like radiation treatment)?

Makes it so much easier when the hospital has all private rooms, you don't need to worry about it.

[eelise11]

In my opinion. and I'm not expert, I'm just about to take NCLEX, but in my opinion, I would think that you would avoid anyone sharing a room with a chemo patient, if possible, because of the immunosuppressed state of the chemo patient. However, if only given the open to share the room, and you had a pregnant patient verses others with illnesses, I'd choose the pregnant patient, assuming they are not ill.

[SoldierNurse22, BSN, RN]

Patients who are receiving their first round of chemo are sometimes hospitalized, especially when they are receiving intensive regimens where the infusions are frequent or long-lasting.

If they are there for a long-term stay, it should be considered that immunocompromised patients can pick up all kinds of weird infections that normal people are immune to, and thus expose the pregnant woman to potentially harmful diseases that may not directly affect her, but could pose a threat to the unborn baby. The pregnant woman could also be carrying germs that are risky to the patient receiving chemo and pose a risk as they nadir and recover. Based on this principal alone, I'd strongly discourage rooming a patient on active chemotherapy with any other patient.

However, one must consider that chemo is commonly excreted in sweat, urine, etc. If they are sharing a bathroom or there is an accident with the patient on chemo, risk of exposure is much higher due to the proximity.

[souleater11]

hi soldier nurse,

correct me if I am wrong but my understanding is that Unsealed radiation source pose a danger due to radioactive urine but Chemo drugs is not.

[SoldierNurse22, BSN, RN]

That is incorrect. Radiation obviously poses a threat. However, certain types of chemotherapy are excreted in sweat and urine. Hence, clothing, bed sheets, etc. contain varying concentrations of chemo.

For instance, Methotrexate is an example of a chemo drug that is almost entirely excreted by the kidneys. Handling the urine of a patient who has received MTX requires the nurse/tech to use chemo-resistant gloves and gowns and cover the toilet during the flush.

[souleater11]

Thanks SoldierNurse for your informative correction :) and I verified your answer.

Methotrexate (Rheumatrex, Trexall) Uses, Dosage, Side Effects - Drugs.com

What should I avoid while taking methotrexate?

Methotrexate can pass into body fluids (including urine, feces, vomit, semen, lady partsl fluid). For at least 48 hours after you receive a dose, avoid allowing your body fluids to come into contact with your hands or other surfaces. Patients and caregivers should wear rubber gloves while cleaning up body fluids, handling contaminated trash or laundry or changing diapers. Wash hands before and after removing gloves. Wash soiled clothing and linens separately from other laundry.

Body fluids should not be handled by a woman who is pregnant or who may become pregnant.

[molls4]

However, one must consider that chemo is commonly excreted in sweat, urine, etc. If they are sharing a bathroom or there is an accident with the patient on chemo, risk of exposure is much higher due to the proximity.

SoldierNurse is absolutely right. Sharing rooms with a chemo patient is a bad idea if pregnant. In pharm, we learned a ton of prototype chemo drugs are pregnancy category X and a lot of them are excreted in bodily fluids. When nurses empty bed pans, gloves are required (even more than just regular bodily fluid prevautions). Gloves are required for opening some oral chemo meds too because they can cause birth defects if a pregnant woman is handling. Other precautions like closing lids on toilets when flushing are recommended because of aerosols, etc. It was my understanding from Pharm that most chemo patients have private rooms anyway. Someone may have said that too in an above post.