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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Study Plan for Study Skills, Test Taking for the NCLEX® Using Med-Surg (Lewis 10th ed.) designed for Westmoreland County Community College

Concepts Covered:

  • Concepts of Population Health
  • Factors Influencing Community Health
  • Community Health Overview
  • Substance Abuse Disorders
  • Upper GI Disorders
  • Renal Disorders
  • Newborn Care
  • Integumentary Disorders
  • Tissues and Glands
  • Central Nervous System Disorders – Brain
  • Digestive System
  • Urinary Disorders
  • Urinary System
  • Musculoskeletal Trauma
  • Concepts of Mental Health
  • Health & Stress
  • Developmental Theories
  • Fundamentals of Emergency Nursing
  • Communication
  • Basics of NCLEX
  • Test Taking Strategies
  • Prioritization
  • Delegation
  • Emotions and Motivation
  • Integumentary Disorders
  • Legal and Ethical Issues
  • Basic
  • Preoperative Nursing
  • Labor and Delivery
  • Fetal Development
  • Newborn Complications
  • Postpartum Complications
  • Postpartum Care
  • Labor Complications
  • Pregnancy Risks
  • Prenatal Concepts
  • Circulatory System
  • Cardiac Disorders
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Postoperative Nursing
  • Intraoperative Nursing
  • Oncology Disorders
  • Neurological Emergencies
  • Respiratory Disorders
  • Female Reproductive Disorders
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Lower GI Disorders
  • Disorders of Pancreas
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Immunological Disorders
  • Hematologic Disorders
  • EENT Disorders
  • Integumentary Important Points
  • Musculoskeletal Disorders
  • Emergency Care of the Neurological Patient
  • Peripheral Nervous System Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Neurologic and Cognitive Disorders
  • Eating Disorders
  • Noninfectious Respiratory Disorder
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Psychological Emergencies
  • Trauma-Stress Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Bipolar Disorders
  • Depressive Disorders
  • Psychotic Disorders
  • Anxiety Disorders
  • Somatoform Disorders
  • Infectious Disease Disorders
  • Musculoskeletal Disorders
  • Renal and Urinary Disorders
  • Cardiovascular Disorders
  • EENT Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Oncologic Disorders
  • Endocrine and Metabolic Disorders
  • Childhood Growth and Development
  • Adulthood Growth and Development
  • Medication Administration
  • Nervous System
  • Dosage Calculations
  • Learning Pharmacology
  • Prefixes
  • Suffixes

Study Plan Lessons

Communicable Diseases
Disasters & Bioterrorism
Cultural Care
Environmental Health
Technology & Informatics
Epidemiology
Health Promotion & Disease Prevention
Head to Toe Nursing Assessment (Physical Exam)
Enteral & Parenteral Nutrition (Diet, TPN)
Specialty Diets (Nutrition)
Blood Glucose Monitoring
Intake and Output (I&O)
Hygiene
Pain and Nonpharmacological Comfort Measures
Bowel Elimination
Urinary Elimination
Complications of Immobility
Patient Positioning
Defense Mechanisms
Overview of Developmental Theories
Abuse
Therapeutic Communication
Overview of the Nursing Process
Triage
Prioritization
Delegation
Maslow’s Hierarchy of Needs in Nursing
Isolation Precaution Types (PPE)
Fall and Injury Prevention
Fire and Electrical Safety
Brief CPR (Cardiopulmonary Resuscitation) Overview
HIPAA
Advance Directives
Legal Considerations
Process of Labor
Fetal Circulation
Fetal Environment
Newborn of HIV+ Mother
Hyperbilirubinemia (Jaundice)
Transient Tachypnea of Newborn
Meconium Aspiration
Babies by Term
Newborn Reflexes
Body System Assessments
Newborn Physical Exam
Postpartum Hemorrhage (PPH)
Mastitis
Initial Care of the Newborn (APGAR)
Breastfeeding
Postpartum Discomforts
Postpartum Physiological Maternal Changes
Dystocia
Precipitous Labor
Preterm Labor
Abruptio Placentae (Placental abruption)
Placenta Previa
Prolapsed Umbilical Cord
Fetal Heart Monitoring (FHM)
Leopold Maneuvers
Mechanisms of Labor
Fetal Development
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Gestational HTN (Hypertension)
Hydatidiform Mole (Molar pregnancy)
Ectopic Pregnancy
Disseminated Intravascular Coagulation (DIC)
Gestational Diabetes (GDM)
Nutrition in Pregnancy
Chorioamnionitis
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Maternal Risk Factors
Fundal Height Assessment for Nurses
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Menstrual Cycle
Hemodynamics
Normal Sinus Rhythm
Performing Cardiac (Heart) Monitoring
Preload and Afterload
Sinus Bradycardia
Sinus Tachycardia
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Angina
Pacemakers
Nursing Care and Pathophysiology of Hypertension (HTN)
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
Discharge (DC) Teaching After Surgery
Postoperative (Postop) Complications
Post-Anesthesia Recovery
Malignant Hyperthermia
Moderate Sedation
Local Anesthesia
Preoperative (Preop)Assessment
General Anesthesia
Preoperative (Preop) Nursing Priorities
Preoperative (Preop) Education
Informed Consent
Biopsy
Ultrasound
Echocardiogram (Cardiac Echo)
Cardiovascular Angiography
Cerebral Angiography
Magnetic Resonance Imaging (MRI)
X-Ray (Xray)
Computed Tomography (CT)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Dialysis & Other Renal Points
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Crohn’s Disease
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Pancreatitis
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Diabetes Management
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Addisons Disease
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Oncology Important Points
Lymphoma
Leukemia
Blood Transfusions (Administration)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Glaucoma
Macular Degeneration
Hearing Loss
Fractures
Cataracts
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Burn Injuries
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Seizure
Seizure Therapeutic Management
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Stroke Nursing Care (CVA)
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Therapeutic Management (CVA)
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Miscellaneous Nerve Disorders
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Cerebral Perfusion Pressure CPP
Intracranial Pressure ICP
Adjunct Neuro Assessments
Levels of Consciousness (LOC)
Routine Neuro Assessments
Hemoglobin A1c (HbA1C)
Glucose Lab Values
Urinalysis (UA)
Creatinine (Cr) Lab Values
Blood Urea Nitrogen (BUN) Lab Values
Ammonia (NH3) Lab Values
Cholesterol (Chol) Lab Values
Albumin Lab Values
Coagulation Studies (PT, PTT, INR)
Platelets (PLT) Lab Values
White Blood Cell (WBC) Lab Values
Hematocrit (Hct) Lab Values
Red Blood Cell (RBC) Lab Values
Hemoglobin (Hbg) Lab Values
Chloride-Cl (Hyperchloremia, Hypochloremia)
Sodium-Na (Hypernatremia, Hyponatremia)
Potassium-K (Hyperkalemia, Hypokalemia)
Hypertonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Isotonic Solutions (IV solutions)
Base Excess & Deficit
Metabolic Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Respiratory Alkalosis
Respiratory Acidosis (interpretation and nursing interventions)
ABG (Arterial Blood Gas) Interpretation-The Basics
ABGs Nursing Normal Lab Values
Chest Tube Management
Nursing Care and Pathophysiology of Pneumonia
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Nursing Care and Pathophysiology for Asthma
Suicidal Behavior
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Mood Disorders (Bipolar)
Depression
Schizophrenia
Generalized Anxiety Disorder
Post-Traumatic Stress Disorder (PTSD)
Somatoform
Dissociative Disorders
Anxiety
Pertussis – Whooping Cough
Varicella – Chickenpox
Mumps
Rubeola – Measles
Scoliosis
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorders
Spina Bifida – Neural Tube Defect (NTD)
Meningitis
Enuresis
Nephrotic Syndrome
Cerebral Palsy (CP)
Mixed (Cardiac) Heart Defects
Obstructive Heart (Cardiac) Defects
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Congenital Heart Defects (CHD)
Cystic Fibrosis (CF)
Asthma
Acute Otitis Media (AOM)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Tonsillitis
Conjunctivitis
Constipation and Encopresis (Incontinence)
Intussusception
Appendicitis
Celiac Disease
Pediatric Gastrointestinal Dysfunction – Diarrhea
Vomiting
Hemophilia
Nephroblastoma
Fever
Dehydration
Sickle Cell Anemia
Burn Injuries
Pediculosis Capitis
Impetigo
Eczema
Growth & Development – School Age- Adolescent
Growth & Development – Preschoolers
Growth & Development – Toddlers
Growth & Development – Infants
Care of the Pediatric Patient
Vitals (VS) and Assessment
Vasopressin
TCAs
SSRIs
Proton Pump Inhibitors
Vancomycin (Vancocin) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Metronidazole (Flagyl) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Parasympatholytics (Anticholinergics) Nursing Considerations
NSAIDs
Nitro Compounds
MAOIs
Hydralazine (Apresoline) Nursing Considerations
Insulin
Magnesium Sulfate
HMG-CoA Reductase Inhibitors (Statins)
Histamine 2 Receptor Blockers
Histamine 1 Receptor Blockers
Epoetin Alfa
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Corticosteroids
Benzodiazepines
Cardiac Glycosides
Calcium Channel Blockers
Parasympathomimetics (Cholinergics) Nursing Considerations
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Autonomic Nervous System (ANS)
Atypical Antipsychotics
Angiotensin Receptor Blockers
ACE (angiotensin-converting enzyme) Inhibitors
Renin Angiotensin Aldosterone System
Complex Calculations (Dosage Calculations/Med Math)
IV Infusions (Solutions)
Injectable Medications
Oral Medications
Basics of Calculations
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
The SOCK Method – K
The SOCK Method – C
The SOCK Method – O
The SOCK Method – S
The SOCK Method – Overview
6 Rights of Medication Administration
Essential NCLEX Meds by Class
12 Points to Answering Pharmacology Questions
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
54 Common Medication Prefixes and Suffixes