Ultrasound Studies, Various Sites (Abdomen, Bladder, Breast, Pelvis, Prostate, Scrotum, Thyroid and Parathyroid Glands)

Ultrasound Studies, Various Sites (Abdomen, Bladder, Breast, Pelvis, Prostate, Scrotum, Thyroid and Parathyroid Glands) is a topic covered in the Davis's Lab & Diagnostic Tests.

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Synonym/Acronym:
Sonography, ultrasound.

Rationale
To visualize and assess solid organs of the abdominal area (including the aorta, bile ducts, bladder, gallbladder, kidneys, liver, pancreas, spleen, and other large abdominal blood vessels), breast, pelvis, prostate, scrotum, thyroid and parathyroid glands. Ultrasound (US) can be used to provide guidance in the performance of biopsies and assist in diagnosing disorders such as aneurysm, cancer, infections, fluid collections, masses, and obstructions. US can also be used to evaluate therapeutic interventions such as organ transplants.

Patient Preparation
There are no food, fluid, activity, or medication restrictions unless by medical direction for US bladder, breast, kidneys, pelvis, prostate, scrotal, thyroid and parathyroid glands. Note any recent procedures that can interfere with abdominal US test results (e.g., surgery, biopsy, barium studies, colonoscopy, endoscopic retrograde cholangiopancreatography). Ensure that interfering studies were performed at least 24 hr before this test or can be rescheduled after this procedure.

  • US Abdomen, Liver and Biliary System, Pancreas, Spleen: Instruct the patient to fast and restrict fluids for 8 hr prior to the procedure; instruct the caregiver of a pediatric patient to have the patient fast and restrict fluids for 8 hr prior to the procedure or as ordered. Patients may be asked to eat a low- or fat-free diet the night before the procedure. Food restrictions help ensure reduction of bowel gas, which can interfere with the transmission of US waves. Protocols may vary among facilities.
  • US Bladder: If required, instruct the patient receiving transabdominal US bladder/pelvis to drink three to four glasses of fluid 90 min before the procedure, and not to void, because the procedure requires a full bladder.
  • US Breast: Instruct the patient not to apply lotions, deodorant, bath powder, or other substances to the chest and breast area before the examination.
  • US Prostate: Inform the patient that a small-volume enema will be administered prior to the procedure to help remove gas or feces that could interfere with the rectal probe; after the enema, a sterile latex- or sheath-covered probe will be inserted into the rectum.

Normal Findings

  • Normal anatomic structures, size, position, and shape; includes associated structures and blood flow/rate.
  • No evidence of congenital anomalies, cysts, nodules, or tumors.
  • Normal subcutaneous, mammary, and retromammary layers of tissue in both breasts; no evidence of pathological lesions (cyst or tumor) in either breast.
  • Absence of renal calculi, cysts, hydronephrosis, obstruction, or tumor.
  • Normal patency of the cystic and common bile ducts.
  • Uniform echo patterns throughout the thyroid and parathyroid glands.

Critical Findings and Potential Interventions

  • Abscess
  • Adnexal torsion
  • Aortic aneurysm measuring 5 cm or more in diameter
  • Appendicitis
  • Infection
  • Testicular torsion
  • Tumor with significant mass effect

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

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