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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My Study Plan (MED-SURG for NCLEX)

Concepts Covered:

  • Respiratory Disorders
  • EENT Disorders
  • Prenatal Concepts
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Integumentary Disorders
  • Oncology Disorders
  • Preoperative Nursing
  • Musculoskeletal Trauma
  • 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
  • Noninfectious Respiratory Disorder
  • Urinary Disorders
  • Vascular Disorders
  • Eating Disorders
  • Lower GI Disorders
  • Intraoperative Nursing
  • Neurologic and Cognitive Disorders
  • Central Nervous System Disorders – Brain
  • Circulatory System
  • Postoperative Nursing
  • Liver & Gallbladder Disorders
  • Central Nervous System Disorders – Spinal Cord
  • Emergency Care of the Cardiac Patient
  • Peripheral Nervous System Disorders
  • Substance Abuse Disorders
  • Female Reproductive Disorders
  • Postpartum Complications
  • Fetal Development
  • Shock
  • Emergency Care of the Neurological Patient
  • Labor and Delivery
  • Postpartum Care
  • Newborn Care
  • Newborn Complications

Study Plan Lessons

ABGs Nursing Normal Lab Values
Glaucoma
Menstrual Cycle
X-Ray (Xray)
ABG (Arterial Blood Gas) Interpretation-The Basics
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Addisons Disease
Burn Injuries
Cataracts
Computed Tomography (CT)
Family Planning & Contraception
Informed Consent
Nursing Care and Pathophysiology for Cushings Syndrome
Macular Degeneration
Magnetic Resonance Imaging (MRI)
Preoperative (Preop)Assessment
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Isotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology for Pancreatitis
Preoperative (Preop) Education
Cerebral Angiography
Hearing Loss
Hypotonic Solutions (IV solutions)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Preoperative (Preop) Nursing Priorities
Respiratory Acidosis (interpretation and nursing interventions)
Thrombocytopenia
Blood Transfusions (Administration)
Cardiovascular Angiography
Fractures
Nursing Care and Pathophysiology for Hyperthyroidism
Hypertonic Solutions (IV solutions)
Integumentary (Skin) Important Points
Preload and Afterload
Respiratory Alkalosis
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Echocardiogram (Cardiac Echo)
Nursing Care and Pathophysiology for Hypothyroidism
Metabolic Acidosis (interpretation and nursing diagnosis)
Performing Cardiac (Heart) Monitoring
Metabolic Alkalosis
Ultrasound
Base Excess & Deficit
Biopsy
Gestation & Nägele’s Rule: Estimating Due Dates
Potassium-K (Hyperkalemia, Hypokalemia)
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
Gravidity and Parity (G&Ps, GTPAL)
Leukemia
Levels of Consciousness (LOC)
Sodium-Na (Hypernatremia, Hyponatremia)
Diabetes Management
Dialysis & Other Renal Points
Local Anesthesia
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Routine Neuro Assessments
Adjunct Neuro Assessments
Chloride-Cl (Hyperchloremia, Hypochloremia)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
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)
Malignant Hyperthermia
Maternal Risk Factors
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Cerebral Perfusion Pressure CPP
Nursing Care and Pathophysiology for Crohn’s Disease
Normal Sinus Rhythm
Physiological Changes
Post-Anesthesia Recovery
Red Blood Cell (RBC) Lab Values
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Cholecystitis
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Hemoglobin (Hbg) Lab Values
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Postoperative (Postop) Complications
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hematocrit (Hct) Lab Values
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
Nutrition in Pregnancy
Pacemakers
White Blood Cell (WBC) Lab Values
Atrial Fibrillation (A Fib)
Platelets (PLT) Lab Values
Coagulation Studies (PT, PTT, INR)
Miscellaneous Nerve Disorders
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Albumin Lab Values
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Cholesterol (Chol) Lab Values
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of Hypertension (HTN)
Ammonia (NH3) Lab Values
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Chorioamnionitis
Nursing Care and Pathophysiology for Menopause
Stroke Assessment (CVA)
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Stroke Therapeutic Management (CVA)
Disseminated Intravascular Coagulation (DIC)
Stroke Nursing Care (CVA)
Ectopic Pregnancy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Blood Urea Nitrogen (BUN) Lab Values
Creatinine (Cr) Lab Values
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Seizure Causes (Epilepsy, Generalized)
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
Seizure Assessment
Nursing Care and Pathophysiology for Distributive Shock
Fetal Circulation
Seizure Therapeutic Management
Urinalysis (UA)
Nursing Care and Pathophysiology for Seizure
Glucose Lab Values
Process of Labor
Hemoglobin A1c (HbA1C)
Mechanisms of Labor
Leopold Maneuvers
Fetal Heart Monitoring (FHM)
Nursing Care and Pathophysiology for Meningitis
Prolapsed Umbilical Cord
Placenta Previa
Abruptio Placentae (Placental abruption)
Preterm Labor
Precipitous Labor
Dystocia
Postpartum Physiological Maternal Changes
Postpartum Discomforts
Breastfeeding
Postpartum Hemorrhage (PPH)
Mastitis
Initial Care of the Newborn (APGAR)
Newborn Physical Exam
Body System Assessments
Newborn Reflexes
Babies by Term
Meconium Aspiration
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Newborn of HIV+ Mother
Hemodynamics
Nursing Care and Pathophysiology for Parkinsons
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)