Transcript Step 12: Ultrasound - PRC Optimization Tool

Session #9
Step 12: Ultrasound
Step 12: Ultrasound
Indication for testing:


Positive Pregnancy Test (ONLY)
Confirm the viability of pregnancy.
 visualize
your baby’s heartbeat within the uterus.
 31% of all pregnancies are not viable. (it could be
miscarriage, ectopic pregnancy, or multiple other
reasons why the pregnancy hormone would be in the
urine).


Confirming how far along she is related to her
last menstrual period (LMP).
Explain what you anticipate before the exam.
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Step 12: Ultrasound
Ultrasound Routine


“Glamor Shot”
Measurements:
 Heart
Rate
 Gestational age measurement (GS and/or CRL)
 Mid Line: TRV and LNG views

Adnexa (same for both right and left)
 RT ADN:
TRV and LNG
 LT ADN: TRV and LNG
 Label and measure ovaries/corpus luteum if seen
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Services
Step 12: Ultrasound
Importance of pt being alone:
Allows her to “feel” and express a reaction
to what she sees
 Offers privacy if needing to do vaginal
ultrasound
 Information of ultrasound (dates, etc) may
add to situation

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Services
Step 12: Ultrasound
Gestational
Age
Gestational
Sac (GS)
Yolk Sac
(YS)
Fetal Heart
Motion
Movements
Development
(visualized)
3-4 wks
+
-
-
-
-
4-5 wks
+
?
-
-
-
5-6 wks
+
+
?
-
-
6-7 wks
+
+
+
-
-
8-9 wks
+
+
+
+
arms, legs
9-10 wks
+
+
+
+
face
11 wks
+
+
+
+
arms & legs
moving, jaw
lines, fingers
and toes
12 wks
+
+
+
+
More clarity
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Step 12: Ultrasound
First Trimester Symptoms:

Frequent urination
 Size

of uterus v bladder capacity
Nausea and vomiting
 Estimated
gestational age, typically subsides
around 12 weeks
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Services
Step 12: Ultrasound
Scope of Information Provided:
Ultrasound Exam
Results
See What You
Expect to See
Confirm Viability
Can not Confirm
Viability
(Before 6 Weeks)
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Didn’t See What
You Expect to See
Can not Confirm
Viability
(After 6 Weeks)
Step 12: Ultrasound
See What You Expect To See:
See What You
Expect to See
Confirm Viability
Can’t Confirm Viability
So, You’re Pregnant
Brochure
Reschedule for
Repeat Ultrasound
Refer to physician
for Prenatal Care
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Step 12: Ultrasound
Saw What you Expect to See
See What You
Expect to See
Confirm Viability
Can’t Confirm
Viability
Give Miscarriage/
Ectopic Pregnancy
Brochure
Reschedule for
repeat ultrasound
one week
Refer her to
physician
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Step 12: Ultrasound
Didn’t See What You Expect to See
Didn’t See What
You Expect to See
Can’t Confirm
Viability
Symptoms  ED
No Symptoms
Call Patient’s OB
For Plan
If no OB,  ED
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Step 12: Ultrasound
What this exam does not include:

Sex of the baby

Diagnosis of pregnancy from an RN or
Sonographer

Diagnosis/Opinion of what is wrong if you
do not see what you expect to see (to the
pt.)
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