Definition
Ultrasonography is a medical imaging technique that uses high-frequency sound waves to create images of internal body structures. It is commonly used to examine organs, tissues, and blood flow without the use of radiation. This technique is widely applied in fields such as obstetrics, cardiology, and abdominal imaging
Purpose
- To delineate the size of the kidneys and to monitor the thickness of the cortex.
- To distinguish between obstruction and parenchymal disease.
- To distinguish between solid cystic masses and to detect the presence of fluid collection, such as urinoma, hematoma, or abscess.
- For early detection of calculi and in diagnosing rejection of transplanted kidney.
- For investigation of solid organs, such as liver, kidneys, pancreas, gallbladder, spleen, and pelvic organs.
- For detecting tumors, granulomas, stones, abscesses, and free fluid.
- Used in obstetrics to determine gestational age.
- For prenatal diagnosis of fetal abnormalities and heart defects.
- For detection of calculi in gallbladder.
Limitations
- It cannot image bones and structures beyond bones. Bones reflect the sound beams and sound waves cannot penetrate beyond bones.
- Limited in its use in the thorax and partly so in the abdomen, since it will not pass through gases.
Preparation
Preparing for an ultrasonography procedure depends on the type of ultrasound being performed. Here are some general guidelines:
General Preparation
- Fasting:
- If the ultrasound involves the abdomen (e.g., liver, gallbladder, pancreas), fasting for 8-12 hours before the procedure is often required to ensure clear imaging.
- Avoid fatty foods before the exam, as they can interfere with the results.
- Hydration:
- For pelvic ultrasounds, drink four to six glasses of water about an hour before the exam and avoid urinating to ensure a full bladder.
- Medication Adjustments:
- Inform your healthcare provider about any medications you are taking, especially blood thinners or diabetes medications, as adjustments may be necessary.
- Clothing and Accessories:
- Wear loose, comfortable clothing and avoid wearing jewelry or metallic items.
- Consent and Communication:
- Discuss the procedure with your healthcare provider, ask any questions, and sign the consent form if required.
Specific Preparations
- Abdominal Ultrasound: Fasting is required; avoid chewing gum to prevent air swallowing.
- Pelvic Ultrasound: A full bladder is necessary for better visualization.
- Thyroid, Musculoskeletal, and Doppler Ultrasounds: No special preparation is needed, but avoid using creams or perfumes before the exam.
Procedure
| Nursing action | Rationale | |
| 1. | Inform the patient the reason for the test and what to expect. | Helps reduce patient’s anxiety. |
| 2. | For an abdominal ultrasound, restrict food and fluids for 8-12 hours prior to the procedure. Sometimes bowel preparation with laxatives is used for viewing the abdominal organs. | Keeps bowel free of waste and gas which may interfere with the results. |
| 3. | For pelvic USG encourage patient to drink fluids. Bladder should be full before the patient is sent for USG. | Full bladder is required to obtain better information about pelvic structures. |
| 4. | Send patient to ultrasound department with case sheet and requisition form. | |
| 5. | Record in chart the timing patient was sent to USG department. | |
| 6. | After receiving patient back in ward following the procedure, record time of arrival. Inform the patient that written report of ultrasonography will be provided by the radiologist. |
Special Consideration
1. Patient-Specific Consideration
- Pregnancy: If the ultrasound is for fetal imaging, ensure the patient follows hydration guidelines for optimal visualization.
- Medical Conditions: Patients with diabetes or kidney disease may need special dietary adjustments before the procedure.
- Allergies: If contrast-enhanced ultrasound is required, check for allergies to contrast agents.
2. Fasting and Hydration
- Abdominal Ultrasound: Requires fasting for 8-12 hours to reduce gas interference.
- Pelvic Ultrasound: Requires a full bladder, so patients should drink four to six glasses of water an hour before the exam.
- Cardiac or Vascular Ultrasound: No fasting required, but caffeine intake may need to be limited.
3. Medication Adjustments
- Patients should inform their healthcare provider about any medications they are taking, especially blood thinners or diabetes medications, as adjustments may be necessary.
4. Clothing and Accessories
- Wear loose, comfortable clothing and avoid wearing jewelry or metallic items that could interfere with imaging.
5. Communication and Consent
- Patients should discuss the procedure with their healthcare provider, ask any questions, and sign the consent form if required.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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