Chapter 2

Question 1

What is access procedures?

Answer 1

Sonographic guidance for fluid, collections, masses, organs
Real time imaging throughout exam
Allows accurate needle and catheter placement

Question 2

Indications for ultrasound

Answer 2

Diagnostic tool confirming pathology
Non-surgical interventions
Fluid aspiration

Question 3

Contraindications for ultrasound

Answer 3

Uncorrectable coagulopathy
Unsafe route
Uncooperative patient

Question 4

What is the Prothrombin Time (PT) target value

Answer 4

1.5-2.0

Question 5

Activated Partial Thromboplastin Time (aPTT) paramaters

Answer 5

1.5-2.5 times baseline value

Question 6

Platelet Count Parameters

Answer 6

50,000-100,000 per microliter

Question 7

Fibrinogen Levels parameter

Answer 7

150-200 (mg/dL)

Question 8

What vascular access can be used with ultrasound

Answer 8

Peripheral IV
Central Lines
Arterial Access

Question 9

Where should the needle be with your transducer?

Answer 9

Same plane as the transducer

Question 10

What is in plane or long axis view

Answer 10

Needle appears as hyper-echoic line

Question 11

What is out of plane or short axis

Answer 11

Needle appears as hyper-echoic dot

Question 12

Difference between Arteries and Veins in Ultrasound

Answer 12

-Arteries have a thicker, more hyperechoic walls
-Veins are more easily compressed than arteries
-Arteries are a high wave form

Question 13

What is static guidance

Answer 13

Ultrasound to locate and evaluate structure

Question 14

What is dynamic guidance

Answer 14

Utilized throughout the duration of the procedure with real time guidance

Question 15

How to keep sterility with sonography guidance

Answer 15

-Access site should be cleaned and sterilized prior to exam
-Sterile procedures using ultrasound will require another person to run the machine
-Ultrasound transducer must also be kept sterile using a dynamic procedure (Probe cover)

Question 16

What do you need for a percutaneous Nephrosotomy Tube Placement

Answer 16

-Local anesthetic
-22-18 g needle
-Guide wire 0.018 or 0.035 in
-Pigtail Drain 8F
-Sedation medications
-Sterile probe cover
-Sterile Gel

Question 17

Paracentesis procedure indictions

Answer 17

-Remove ascites from the abdomen
-Diagnostic and therapeutic purposes
-Clinical indications (cirrhosis)

Question 18

What is a Endovaginal Procedure Saline Infused Sonohysterography (SIS

Answer 18

Used to evaluate the uterine cavity and endometrium

Question 19

Indications of Saline Infused Sonohysterography:

Answer 19

-Fertility concerns
-Endometrial polyps
-Post menopausal bleeding
-Submucosal fibroids
-Retained products of conception

Question 20

Contraindications of Saline infused Sonohysteropgraphy:

Answer 20

-Pregnancy
-IUD placement

Question 21

When should you do the Saline infused Sonohysteropgraphy

Answer 21

-Should be done around day 4-7 of menstrual cycle
-Endovaginal ultrasound be done prior
-Lithotomy position for patient

Question 22

Steps of Saline Infused Sonohysteropgraphy

Answer 22

-Speculum is used to locate cervix
-It is then cleaned with iodine
-Catheter is introduced and balloon inflated when beyond cervix
-Speculum is removed and endovaginal probe is inserted
-Sterile saline is injected through catheter while scanning uterine wall
-Balloon is deflated and catheter is removed

Question 23

What drainage procedures are done with ultrasound?

Answer 23

-Percutaneous drainage of fluid collection
-Percutaneous nephrostomy tube
-Paracentesis
-Thoracentesis