Ultrasound

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Outline

Overview

  1. Ultrasound
    1. View internal organs
    2. Diagnose or guide procedures

Nursing Points

General

  1. Procedure
    1. Transducer probe
      1. Standard (gel on skin)
      2. Transesophageal
      3. Transrectal
      4. Transvaginal
    2. Doppler -> shows blood flow
  2. Indication
    1. Pain
    2. Lumps
    3. Procedure
    4. Has not urinated
    5. Pregnancy
  3. Purpose
    1. View organs and diagnose
    2. Guide biopsies

Assessment

  1. Before
    1. Explain procedure and purpose to patient
    2. Empty bladder
    3. May be NPO 6 hours before (viewing GI system)

Therapeutic Management

  1. During
    1. Position patient according to type of ultrasound
    2. Transesophageal
      1. Numb throat
      2. IV sedation
  2. After
    1. Wipe off gel
    2. Transesophageal -> no eating/drinking until numbness gone

Nursing Concepts

  1. Patient-centered care -> type of US based on symptoms
  2. Perfusion -> doppler shows blood flow

Patient Education

  1. Radiologist will interpret results
  2. Doctor will explain results

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Transcript

Hey guys! Welcome to the lesson on ultrasounds. Let’s get started!

So an ultrasound uses sound waves that bounce off of tissue to view the internal organs and blood flow. They’re used to diagnose and to guide procedures like biopsies. Ultrasounds are also used inside the uterus when a woman is pregnant.Let’s talk about the procedure. 

Ultrasounds use a transducer probe that is placed in the skin to view the organs under that tissue. The standard ultrasound uses an external transducer like in this picture. A bladder scanner for example is where we press the probe against their pelvic area with gel to view the amount of urine in the bladder. A transesophageal ultrasound probe is inserted into the esophagus to view organs like the heart up close. The transrectal ultrasound is inserted rectally for viewing the prostate for example.The transvaginal ultrasound is inserted vaginally and is great for views of the ovaries and uterus especially in early pregnancy. A doppler ultrasound is used to look at blood flow. Why would we need an ultrasound?

The doctor may order an ultrasound if the patient is having pain or lumps somewhere in the body to get a look inside, like if the doctor suspects a clot in the leg. If a patient on our unit hasn’t peed all shift, we check their bladder with our bladder ultrasound that we keep on the unit so that we may call the doctor with the amount of urine being retained to help them decide on new orders. Ultrasounds are used on pregnant women to look at the baby and blood flow. The doctor might also need an ultrasound during a procedure like if they were going to need an ultrasound guided biopsy or injection like in this picture to make sure they are in the correct spot. Let’s explore what to do before the ultrasound. 

So if the doctor orders the ultrasound, explain the procedure and the reason for it to the patient. Have them empty their bladder before hand if they are able to. Sometimes it will be better to keep a full bladder to push the uterus up if that is what they’re looking at. The patient might need to avoid food and drinks before if the ultrasound is to view inside the abdominal area to avoid obstructed views. 

During the ultrasound, you will help position the patient according to the area of the body being viewed. For example, for the bladder ultrasound the patient will lie flat on the bed. You will put the gel on the probe or the patient’s skin for the standard ultrasound. The gel is necessary to help with the sound projection into the skin to get a clear picture. If the patient is having a transesophageal ultrasound, the radiology tech will numb the patient’s throat and you may provide IV sedation to help them relax. 

When the procedure is over, wipe the gel off of the patient’s skin and clean the probe. After a transesophageal, the patient shouldn’t eat or drink anything until the numbness is gone. Let the patient know that they radiologist will interpret the results and the doctor will explain them. In the case of a bladder ultrasound, you as the nurse are able to let the patient know how much urine is in their bladder. 

Okay, so the priority nursing concepts for the patient with an ultrasound are perfusion and patient-centered care. 

Alright guys, let’s review the key points. An ultrasound uses sound waves to view the organs and blood flow in the body using a transducer probe. An ultrasound may be indicated if the patient has pain, lumps, hasn’t urinated all shift, pregnancy, or for procedure guidance. Before the ultrasound, explain the procedure to the patient and why they’re having it. Position the patient according to the area being viewed and put gel on the probe or skin. If the patient is having a transesophageal ultrasound, the patient will need some sedation to help them relax. After it’s over, wipe off the gel and keep the patient NPO until the numbness is gone from the throat. 

Okay guys, that’s it on ultrasounds! Now go out and be your best self today, and as always, happy nursing!

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Final Exam

Concepts Covered:

  • Terminology
  • Urinary System
  • Respiratory Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Oncology Disorders
  • Integumentary Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Respiratory Emergencies
  • Disorders of the Posterior Pituitary Gland
  • Hematologic Disorders
  • Renal Disorders
  • Labor Complications
  • Immunological Disorders
  • Upper GI Disorders
  • Neurological Emergencies
  • Disorders of Pancreas
  • Musculoskeletal Disorders
  • Cardiac Disorders
  • Disorders of the Thyroid & Parathyroid Glands
  • Integumentary Important Points
  • Pregnancy Risks
  • Urinary Disorders
  • Vascular Disorders
  • Central Nervous System Disorders – Brain
  • Nervous System
  • Lower GI Disorders
  • Intraoperative Nursing
  • Eating Disorders
  • Circulatory System
  • Postoperative Nursing
  • Liver & Gallbladder Disorders
  • Emergency Care of the Cardiac Patient
  • Female Reproductive Disorders
  • Shock
  • Respiratory System
  • Substance Abuse Disorders
  • Fetal Development
  • Proteins
  • Noninfectious Respiratory Disorder
  • Newborn Care
  • Statistics
  • Emergency Care of the Neurological Patient
  • Basics of Sociology
  • Bipolar Disorders
  • Infectious Respiratory Disorder

Study Plan Lessons

Diagnostic Testing Course Introduction
Fluid & Electrolytes Course Introduction
X-Ray (Xray)
X-Ray (Xray)
X-Ray (Xray)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Computed Tomography (CT)
Computed Tomography (CT)
Computed Tomography (CT)
Fluid Pressures
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Fluid Shifts (Ascites) (Pleural Effusion)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
CT & MR Angiography
CT & MR Angiography
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Cerebral Angiography
Cerebral Angiography
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Cardiovascular Angiography
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Performing Cardiac (Heart) Monitoring
Ultrasound
Ultrasound
Interventional Radiology
Interventional Radiology
Nuclear Medicine
Cardiac Stress Test
Cardiac Stress Test
Pulmonary Function Test
Pulmonary Function Test
Endoscopy & EGD
Endoscopy & EGD
Colonoscopy
Colonoscopy
Mammogram
Biopsy
Biopsy
Electroencephalography (EEG)
Electroencephalography (EEG)
Electromyography (EMG)
Electromyography (EMG)
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
General Anesthesia
Leukemia
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Moderate Sedation
Oncology Important Points
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malignant Hyperthermia
Phosphorus-Phos
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Post-Anesthesia Recovery
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Heart Failure (CHF)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Sinus Tachycardia
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Discharge (DC) Teaching After Surgery
Pacemakers
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Absolute Neutrophil Count (ANC) Lab Values
Absolute Reticulocyte Count (ARC) Lab Values
Alanine Aminotransferase (ALT) Lab Values
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Alpha-fetoprotein (AFP) Lab Values
Ammonia (NH3) Lab Values
Anion Gap
Antinuclear Antibody Lab Values
Base Excess & Deficit
Beta Hydroxy (BHB) Lab Values
Bicarbonate (HCO3) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
C-Reactive Protein (CRP) Lab Values
Carbon Dioxide (Co2) Lab Values
Carboxyhemoglobin Lab Values
Cardiac (Heart) Enzymes
Cholesterol (Chol) Lab Values
Coagulation Studies (PT, PTT, INR)
Congestive Heart Failure (CHF) Labs
COPD (Chronic Obstructive Pulmonary Disease) Labs
Cortisol Lab Vales
Creatine Phosphokinase (CPK) Lab Values
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Cultures
Cyclic Citrullinated Peptide (CCP) Lab Values
D-Dimer (DDI) Lab Values
Direct Bilirubin (Conjugated) Lab Values
Dysrhythmias Labs
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fibrin Degradation Products (FDP) Lab Values
Fibrinogen Lab Values
Fluid Compartments
Free T4 (Thyroxine) Lab Values
Gamma Glutamyl Transferase (GGT) Lab Values
Glomerular Filtration Rate (GFR)
Glucagon Lab Values
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Growth Hormone (GH) Lab Values
Hematocrit (Hct) Lab Values
Hemodynamics
Hemoglobin (Hbg) Lab Values
Hemoglobin A1c (HbA1C)
Hepatitis B Virus (HBV) Lab Values
Homocysteine (HCY) Lab Values
Ionized Calcium Lab Values
Iron (Fe) Lab Values
Ischemic (CVA) Stroke Labs
Lab Panels
Lab Values Course Introduction
Lactate Dehydrogenase (LDH) Lab Values
Lactic Acid
Lipase Lab Values
Lithium Lab Values
Liver Function Tests
Mean Corpuscular Volume (MCV) Lab Values
Mean Platelet Volume (MPV) Lab Values
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
Methemoglobin (MHGB) Lab Values
Myoglobin (MB) Lab Values
Order of Lab Draws
Pediatric Bronchiolitis Labs
Phosphorus (PO4) Blood Test Lab Values
Platelets (PLT) Lab Values
Pneumonia Labs
Potassium-K (Hyperkalemia, Hypokalemia)
Prealbumin (PAB) Lab Values
Pregnancy Labs
Procalcitonin (PCT) Lab Values
Prostate Specific Antigen (PSA) Lab Values
Protein (PROT) Lab Values
Protein in Urine Lab Values
Red Blood Cell (RBC) Lab Values
Red Cell Distribution Width (RDW) Lab Values
Renal (Kidney) Failure Labs
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Sepsis Labs
Shorthand Lab Values
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Total Bilirubin (T. Billi) Lab Values
Total Iron Binding Capacity (TIBC) Lab Values
Triiodothyronine (T3) Lab Values
Troponin I (cTNL) Lab Values
Urinalysis (UA)
Urine Culture and Sensitivity Lab Values
Vitamin B12 Lab Values
Vitamin D Lab Values
White Blood Cell (WBC) Lab Values