Description
Ultrasound is the transmission of low energy, high frequency waves through a medium such as fluid or tissue. The echoes received by the transducer crystals are converted to electric signals and displayed on a monitor. The intensity and delay time for reflected echoes are recorded which are interpreted to arrive at data regarding the fetus and the intrauterine environment.
Purposes
- To diagnose pregnancy as early as 6 weeks of gestation.
- To confirm the size and location of placenta and amount of amniotic fluid.
- To identify the growth of the fetus and to detect any gross abnormality.
- To diagnose presentation and position of the fetus.
- To predict maturity of the fetus.
- To confirm suspected ectopic pregnancy.
- To locate an intrauterine contraceptive device (IUCD).
- To confirm suspected multiple gestation, placenta previa, and cord presentation.
- As an adjunct to cervical encirclage, amniocentesis, and external version.
- To estimate fetal growth and normalcy.
- To establish gestational age.
- To obtain BPP for determining fetal well-being.
Articles
- Ultrasound machine with transducer.
- Ultrasound gel/coupling gel.
- A gown for the patient.
Procedure
| Nursing actions | Rationale | |
| 1. | Transabdominal ultrasound scan Explain to the woman, the nature of examination, purpose, and her role. | Reduces anxiety and helps in obtaining cooperation. |
| Instruct the woman to drink eight glasses of water in 2 hours prior to the examination if in the first trimester of pregnancy (in second and third trimesters, drinking water is not necessary). Instruct the woman not to void until examination is over. | Having the patient drink water will distend her bladder. Distended bladder displaces bowel out of the pelvis, lifts the uterus from behind the symphysis pubis, and produces an acoustic window enabling optimal imaging of the uterine contents. During the second and third trimester of pregnancy, amniotic fluid serves as an acoustic window while the gravid uterus displaces the bowel. Exposure of abdomen from the costal margin to symphysis pubis will provide a complete area for visualization. | |
| Assist the patient to wear a hospital gown. | ||
| The patient is assisted to lie in supine position on the examining table and expose her abdomen from costal margin to symphysis pubis. | ||
| Apply the ultrasound gel or coupling gel generously to the abdomen (a towel or disposable tissues should be provided to the patient to protect. her clothing). The physician/radiologist moves the transducer on the abdomen for obtaining maximum visualization and identification. | Ultrasound gel eliminates the air interface between ultrasound transducer and patient’s skin, thereby providing better transmission and reflection of the ultrasound waves. | |
| After completion of procedure, remove gel from the woman’s abdomen and assist her to dress back into her clothes. | Leaves mother comfortable after completion of the procedure. | |
| 2. | Transvaginal ultrasound examination No pre-examination preparation is required. | No acoustic window is required for a transvaginal scan because the transducer is indirect contact with pelvic organs. |
| Explain procedure to the patient. | Reduces anxiety and helps in obtaining cooperation. | |
| Instruct patient to remove any clothing below waist. | ||
| Place the woman in lithotomy position and place a pillow under her buttocks to raise the pelvic area. | Elevating the patient’s hips will provide better imaging of pelvic organs. | |
| Place a transducer sheath or a condom filled with ultrasound gel over the vaginal transducer. | Ultrasound gel will eliminate the air interface. Lubricant applied to the transducer reduces discomfort. Lubricant applied outside the sheath increases the ease of insertion. | |
| The transducer is then inserted through the introitus into the mid vagina by radiologist. | ||
| Remove the condom after the examination and clean the transducer with disinfectant (Cidex). | ||
| Assist the woman to clean herself and change to her clothes Forward the findings of the ultrasound scan to the unit or physician who has requested the test. | ||
| Wash hands and record the procedure and findings |
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 Kluwer’s, ISBN-13:978-9388313285
- Annamma Jacob, Manual of Midwifery and Gynaecological Nursing, 4th Edition, 2023, Jaypee Publishers, ISBN: 978-9356961593
- 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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