ULTRASOUND (U.S.G.

Introduction-

It’s also known abdominal ultrasound, abdomen sonography

Common Use:-

To visualize and assess the solid organs of the abdomen, including the aorta, bile ducts,
gallbladder, kidneys, pancreas, spleen, and other large abdominal blood vessels. This study is
used to perform biopsies and assist in diagnosing disorders such as aortic aneurysm, infections,
fluid collections, masses, and obstructions. This procedure can also be used to evaluate
therapeutic interventions such as organ transplants.

Area of Application:-

Abdomen from the xiphoid process to the umbilicus.

Contrast:-

Done without contrast.

Description:-

Ultrasound (US) procedures are diagnostic, noninvasive, and relatively inexpensive. They
take a short time to complete, do not use radiation, and cause no harm to the patient. High-
frequency sound waves of various intensities are delivered by a transducer, a flashlight-shaped
device, pressed against the skin. The waves are bounced back off internal anatomical structures
and fluids, converted to electrical energy, amplified by the transducer, and displayed as images
on a monitor. US is often used as a diagnostic and therapeutic tool for guiding minimally
invasive procedures such as needle biopsies and fluid aspiration (paracentesis). The
contraindications and complications for biopsy and fluid aspiration are discussed in detail in the
individual monographs.
Abdominal US is valuable in determining aortic aneurysms, the internal components of organ
masses (solid versus cystic), and for evaluating other abdominal diseases, ascites, and abdominal
obstruction. Abdominal US can be performed on the same day as a radionuclide scan or other
radiological procedure and is especially valuable in patients who have hypersensitivity to
contrast medium or are pregnant. US is also widely used for pediatric patients to help diagnose
appendicitis and for infants to assign cause for recurrent vomiting.

Indications-

 Determine the patency and function of abdominal blood vessels, including the abdominal
aorta; vena cava; and portal, splenic, renal, and superior and inferior mesenteric veins
 Detect and measure an abdominal aortic aneurysm
 Monitor abdominal aortic aneurysm expansion to prevent rupture
 Determine changes within small aortic aneurysms pre- and postsurgery
 Evaluate abdominal ascites
 Evaluate size, shape, and pathology of intra-abdominal organs

Potential Diagnosis-

Normal Findings In:

Absence of ascites, aortic aneurysm, cysts, obstruction, or tumors

Normal size, position, and shape of intra-abdominal organs and associated structures

Abnormal Findings In:

 Abdominal abscess, ascitic fluid, or hematoma

 Aortic aneurysm greater than 4 cm
 Congenital absence or malplacement of organs
 Gallbladder or renal calculi
 Tumor, liver, spleen, or retroperitoneal space

Nursing Implications Procedure-

Pretest-
 Positively identify the patient using at least two unique identifiers before providing care,
treatment, or services.
 Inform the patient this procedure can assist in assessing abdominal abnormalities.
 Obtain a history of the patient’s complaints or clinical symptoms, including a list of
known allergens, especially allergies or sensitivities to latex.
 Obtain a history of results of the patient’s cardiovascular, gastrointestinal, genitourinary,
and hepatobiliary systems, symptoms, and results of previously performed laboratory
tests, diagnostic and surgical procedures.
 Note any recent procedures that can interfere with test results (i.e., barium procedures,
surgery, or biopsy). There should be 24 hours between administration of barium and this
test.
 Endoscopic retrograde cholangiopancreatography, colonoscopy, and computed
tomography of the abdomen, if ordered, should be scheduled after this procedure.
 Obtain a list of the patient’s current medications, including herbs, nutritional
supplements, and nutraceuticals (see Laboratory Critical Findings online at DavisPlus).
 Review the procedure with the patient. Address concerns about pain related to the
procedure. Explain to the patient that there may be moments of discomfort experienced
during the test. Inform the patient that the procedure is performed in a ultrasound
department, by a health-care provider (HCP) specializing in this procedure, with support
staff, and takes approximately 30 to 60 minutes.
 Sensitivity to social and cultural issues, as well as concern for modesty, is important in
providing psychological support before, during, and after the procedure.
 Instruct the patient to remove jewelry and other metallic objects in the area to be
examined.
 Note that there are no food or fluid restrictions for US of the aorta. Restrictions for US
studies of other abdominal organs may be imposed by medical direction.

Intra test-

Potential Complications:-

 Observe standard precautions, and follow the general guidelines in Patient Preparation
and Specimen Collection. Positively identify the patient.
 Ensure that food and fluids have been restricted, if required, prior to the procedure.
 Ensure that the patient has removed external metallic objects prior to the procedure.
 Instruct the patient to void prior to the procedure and to change into the gown, robe, and
foot coverings provided.
 Instruct the patient to cooperate fully and to follow directions. Instruct the patient to
remain still throughout the procedure because movement produces unreliable results.
 Place the patient in the supine position on an examination table. The right- or left-side-up
positions may be used to allow gravity to reposition the liver, gas, and fluid to facilitate
better organ visualization.
 Expose the abdominal area and drape the patient.
 Conductive gel is applied to the skin, and a Doppler transducer is moved over the skin to
obtain images of the area of interest.
 Ask the patient to breathe normally during the examination. If necessary for better organ
visualization, ask the patient to inhale deeply and hold his or her breath.

Post Test-

 Inform the patient that a report of the results will be sent to the requesting HCP, who will
discuss the results with the patient.
 When the study is completed, remove the gel from the skin.
 Instruct the patient to resume usual diet and fluids, as directed by the HCP.
 Recognize anxiety related to test results. Discuss the implications of abnormal test results
on the patient’s lifestyle. Provide teaching and information regarding the clinical
implications of the test results, as appropriate.
 Reinforce information given by the patient’s HCP regarding further testing, treatment, or
referral to another HCP. Answer any questions or address any concerns voiced by the
patient or family.
 Depending on the results of this procedure, additional testing may be needed to evaluate
or monitor progression of the disease process and determine the need for a change in
therapy. Evaluate test results in relation to the patient’s symptoms and other tests
performed.