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01.08 Ultrasound

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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

Reference Links

Video 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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