ULTRASOUND.

Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging method that uses high-frequency sound waves to produce relatively precise images of structures within your body. The images produced during an ultrasound examination often provide valuable information for diagnosing and treating a variety of diseases and conditions. Most ultrasound examinations are done using a sonar device outside of your body, though some ultrasound examinations involve placing a device inside your body. Why it's done You may need to undergo an ultrasound for a variety of reasons. Ultrasound may be used, for example, to: Assess a fetus Diagnose gallbladder disease Evaluate flow in blood vessels Guide a needle for biopsy or tumor treatment Evaluate a breast lump Check your thyroid gland Study your heart Diagnose some forms of infection Diagnose some forms of cancer Reveal abnormalities in the genitalia and prostate Evaluate abnormalities of the muscles and tendons Risks Diagnostic ultrasound is a safe procedure that uses low-power sound waves. There are no direct risks from a diagnostic ultrasound exam. How you prepare How you prepare for an ultrasound depends on which area of your body needs evaluation: Most ultrasound exams require no preparation. Other exams such as of the gallbladder require that you forgo food and liquids for up to six hours before the exam. Still other exams such as a pelvic ultrasound require that you not urinate before the exam to ensure that your bladder will be full, allowing better visualization of the uterus, ovaries or prostate. When scheduling your ultrasound, ask your doctor for specific instructions for your particular exam. Most ultrasound procedures do not require advance preparation. The exceptions are listed below: Abdominal Ultrasound and Abdominal Ultrasound with Doppler (Liver, Spleen, Gallbladder, Kidneys, Pancreas, Abdominal Aorta, Biliary System) (exam time: 30 min; visit time about 1 1/2 hours) Adults: Do not eat or drink 8 hours before exam. Children: Do not eat or drink 4 hours before study or skip 1 meal. Take medications with a small sip of water. If you are diabetic, please take your insulin. Pelvic Ultrasound (Uterus, Ovaries, Fallopian Tubes, Urinary Bladder) (exam time: 30 min; visit time about 1 1/2 hours) Our protocol is to include transvaginal ultrasound for females. Eat normally. One hour before your exam, drink 32 oz. of water. Do not empty your bladder before your exam. Bladder Ultrasound For both male and female patients, one hour before your exam, drink 32 oz. of water. Prostate-Transrectal Ultrasound Two hours before your exam, do a cleansing with a Fleet Enema #1. Hysterosonogram No unprotected sexual relations during the first 10 days of your menstrual cycle.

Ultrasound-guided biopsies Ultrasound breast biopsy You must be off Aspirin, blood thinners and vitamin E for 7 days prior to your biopsy. Liver biopsy/ Paracentesis Ultrasound /Thoracentesis/Prostate biopsy Do not eat or drink after midnight the day before your biopsy. You must be off Aspirin, blood thinners and vitamin E for 7 days before your biopsy. What you can expect During an ultrasound exam, you usually lie on an examination table. A small amount of gel is applied to your skin. The gel helps eliminate the formation of air pockets between the ultrasound and your body. During the exam, a technician trained in ultrasound imaging (sonographer) presses a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined, moving from one area to another as necessary. Based on the same principles as sonar, a technology used to detect underwater objects, the transducer generates and receives high-frequency sound waves that can't be heard by the human ear. As the sonographer places the transducer on your skin, crystals inside the transducer emit pulses of sound waves that travel into your body. Your tissues, bones and body fluids reflect the sound waves and bounce them back to the transducer. The transducer then sends this information to a computer, which composes detailed images based on the patterns created by the sound waves. Though the majority of ultrasound exams are performed with a transducer on your skin, some ultrasounds are done inside your body (invasive ultrasounds). For these exams, a specialized transducer is attached to a probe that's inserted into a natural opening in your body. Examples of these exams include: Transesophageal echocardiogram. A small, specialized transducer is inserted into your esophagus to obtain images of the nearby heart. Such exams are typically performed with sedation. Transrectal ultrasound. A small, specialized transducer is inserted into a man's rectum to view his prostate. Transvaginal ultrasound. A small, specialized transducer is inserted into a woman's vagina to view her uterus and ovaries. Ultrasound is usually a painless procedure. However, you may experience some mild discomfort as the sonographer guides the transducer over your body, especially if you're required to have a full bladder. A typical ultrasound exam takes from 30 minutes to an hour. Nursing Responsibilities: Cleanse bowel Distend bladder (1L of waterp.o.) Withhold voiding BEFORE Procedure: Before an ultrasound, the woman needs a good explanation of what will happen. Also tell her that it is safe for the father of the baby to remain in the room during the test. To ensure that the mother has a full bladder at the time of the procedure, she should drink a full glass of water every 15 minutes beginning an hour and a half before the procedure. Instruct the mother not to void before the procedure. DURING Procedure: Explain to patient the procedure and its purpose. The ultrasound technician may apply a clear gel to the skin in order to help the transducer more freely over the body. Ask the patient to relax while the procedure is going on. AFTER Procedure: Allow mother to void. Allow the mother to take home a photograph of the sonogram image which can enhance bonding because it is a proof that the pregnancy exists and that the fetus appears well.

URINALYSIS
This test is performed to assess the effects of cardiovascular disease on renal function and the existence of concurrent renal or systemic disease ex. Glumorulonephritis, hypertension and diabetes Urinalysis is a test that evaluates a sample of your urine. Urinalysis is used to detect and assess a wide range of disorders, including urinary tract infection, kidney disease and diabetes. Urinalysis involves examining the appearance, concentration and content of urine. Abnormal urinalysis results may point to a disease or illness. For example, a urinary tract infection can make urine look cloudy instead of clear. Increased levels of protein in urine can be a sign of kidney disease. Abnormal results of a urinalysis often require additional testing and further evaluation to uncover the source of the problem. Why it's done Urinalysis is a common test that's done for several reasons: To assess your overall health. Your doctor may recommend urinalysis as part of a routine medical examination, pregnancy checkup, pre-surgery preparation, or on hospital admission to screen for a variety of disorders, such as diabetes, kidney disease and liver disease. To diagnose a medical condition. Your doctor may suggest urinalysis if you're experiencing abdominal pain, back pain, frequent or painful urination, blood in your urine or other urinary problems. Urinalysis may help diagnose the cause of these symptoms. To monitor a medical condition. If you've been diagnosed with a medical condition, such as kidney disease or urinary tract disease, your doctor may recommend urinalysis on a regular basis to monitor your condition and treatment. Other tests, such as pregnancy testing and drug screening, also may require a sample of urine. These tests are separate from urinalysis. They test for substances in the urine that urinalysis typically doesn't include. For example, pregnancy testing measures the hormone human chorionic gonadotropin (HCG). Drug screening tests are tailored to detect specific drugs or their metabolic products, depending on the purpose of the testing. How you prepare If your urine is being tested only for urinalysis, you can eat and drink normally before the test. If you are having other tests at the same time, you may need to fast for a certain amount of time before the test. Your doctor will give you specific instructions. Many drugs, including nonprescription medications and vitamins, can affect the results of a urinalysis. Before a urinalysis, tell your doctor about any medications or vitamins you're taking. What you can expect You need to provide a urine sample for urinalysis. Depending on your situation, you may collect the sample at home or at your doctor's office. Your doctor will provide a container for the urine sample. You may be asked to collect the sample first thing in the morning because at that time your urine is more concentrated, and abnormal results may be more obvious. To obtain the most accurate results, the sample may need to be collected midstream, using a clean-catch method. This method involves the following steps: Cleanse the urinary opening. Women should spread their labia and clean from front to back. Men should wipe the tip of the penis. Begin to urinate into the toilet. Stop urinating briefly. Urinate at least 2 ounces (about 59 milliliters) into the collection container. Finish urinating into the toilet. Deliver the sample as directed by your doctor. If you can't deliver the sample to the designated area within 30 minutes of collection, refrigerate the sample, unless you've been instructed otherwise by your doctor. In some cases, your doctor may insert a thin, flexible tube (catheter) through the urinary tract opening and into the bladder to collect the urine sample. The urine sample is sent to a lab for analysis. You can return to your usual activities immediately. Nursing Considerations for Routine Urinalysis 1. Instruct the patient to void directly into a clean, dry container. Sterile, disposable containers are recommended. Women should always have a clean-catch specimen if a microscopicexamination is ordered. Feces, discharges, vaginal secretions and menstrual blood will contaminate the urine specimen. 2. Collect specimens form infants and young children into a disposable collection apparatus consisting of a plastic bag with an adhesive backing around the opening that can be fastened to the perineal area or around the penis to permit voiding directly to the bag. Depending on hospital policy, the collected urine can be transferred to an appropriate specimen container. 3. Cover all specimens tightly, label properly and send immediately to the laboratory. 4. If a urine sample is obtained from an indwelling catheter, it may be necessary to clamp the catheter for about 15-30 minutes before obtaining the sample. Clean the specimen port with antiseptic before aspirating the urine sample with a needle and a syringe. 5. Observe standard precautions when handling urine specimens. 6. If the specimen cannot be delivered to the laboratory or tested within an hour, it should be refrigerated or have an appropriate preservative added.