Self-Care Home testing

What is the first question you want to ask a patient before measuring their blood pressure?

"When was the last time you used tobacco-containing products or drank a caffeinated beverage?" -Do not use *tobacco* products or drink *caffeine*-containing beverages for at least 30 minutes before taking a BP measurement. These activities can increase blood pressure.

Some of the drug test kits include telephone counseling to:

(1) help parents recognize the signs of drug use (2) assist in creating a family drug policy (3) emphasize that parents should *use the test to develop trust and open communication* within their families, *rather than to intimidate with the threat of random testing*. Some telephone counseling programs provide referrals to rehabilitation and counseling services in the family's community.

What is the wait time for a test result after applying the urine to the prego testing device?

*1-5 minutes* -may get false-negative if don't wait long enough Waiting the maximum allowed time may improve the sensitivity of the test.

Which UTI test ket is the best and why?

*AZO Test Strips* -Because it *detects BOTH nitrite and leukocyte esterase (LE)*. Combining nitrite and LE or urinary protein in one test not only increases overall sensitivity and specificity but also decreases the risk of false-negative results. Leukocyte esterase (LE) is an enzyme unique to leukocytes (white blood cells). White blood cells may be found in the urine when a UTI is present.

Which home pregnancy test has the most sensitivity?

*First Response Early Result* -this test has 90% accuracy when used on the first day of their missed menses, so it is a good choice for someone who wants to detect their pregnancy early. -If the patient doesn't need an early detection, then they should go with a different product based on cost. -e.g. if they have missed a month or so of their period, there should be plenty hCG available in the urine to detect pregnancy with any home test kit.

*How to read BP using the Auscultatory method* The detection device, which is usually indicated on the cuff with a tab or other marking, is placed directly over the brachial artery. As cuff pressure increases during the measurement procedure, the brachial artery is compressed and blood flow is obstructed. As cuff pressure is gradually released, blood flow is reestablished and Korotkoff's sounds can be heard in different phases. Phase I, which corresponds to ________ pressure, can be identified when at least two consecutive "beats" are heard as cuff pressure is decreased. The nature of the sounds changes over the next three phases. _________ pressure is identified at the point the sounds disappear (Phase V).

*How to read BP using the Auscultatory method* The detection device, which is usually indicated on the cuff with a tab or other marking, is placed directly over the brachial artery. As cuff pressure increases during the measurement procedure, the brachial artery is compressed and blood flow is obstructed. As cuff pressure is gradually released, blood flow is reestablished and Korotkoff's sounds can be heard in different phases. Phase I, which corresponds to *systolic* pressure, can be identified when at least two consecutive "beats" are heard as cuff pressure is decreased. The nature of the sounds changes over the next three phases. *Diastolic* pressure is identified at the point the sounds disappear (Phase V). Measure the blood pressure as directed by the product instructions. If using a *stethoscope*, listen for the Korotkoff's sounds as defined: *Phase 1*: Sound begins as a soft tapping. Record the *systolic* pressure when two taps are heard in sequence. *Phase 2*: Tapping sound becomes louder and is accompanied by a swishing sound or murmur. *Phase 3*: Tapping sounds persist, but the swishing or murmur sound stops. *Phase 4*: There is muffling or softening of tapping sounds. *Phase 5*: Sound stops. Record the *diastolic* pressure when the sound stops. Using the *same* arm, take *two to three* measurements separated by at least *2 minutes*. Record the results, arm used, time and date of measurement, and *name and time of last dose of any medications*, including antihypertensive medications.

*Interferences for Fecal Occult Blood Tests* 1. Women who are ________ should delay testing until _______ has ceased. 2A. Which meds may cause sufficient gastric bleeding to produce positive results? 2B. These medications should be avoided for at least ____ days before testing and _______ the test period. 3. Vitamin ____ ingestion in excess of 250 mg/day may interfere with the peroxidase action of hemoglobin, causing false-negative results. Patients should stop taking it ___ days before testing. 4. The FOBTs are not specific for human blood and may produce false-positive results if ______ is consumed. 5. Toilet bowl ______ may produce false-positive results.

*Interferences for Fecal Occult Blood Tests* 1. Women who are *menstruating* should delay testing until *menses* has ceased. 2A. Aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), and steroids may cause sufficient gastric bleeding to produce positive results. 2B. These medications should be avoided for at least *2-3* days before testing and *during* the test period. 3. Vitamin *C* ingestion in excess of 250 mg/day may interfere with the peroxidase action of hemoglobin, causing false-negative results. Patients should stop taking it *2-3* days before testing. 4. The FOBTs are not specific for human blood and may produce false-positive results if *red meat* is consumed. 5. Toilet bowl *cleaners* may produce false-positive results.

For which population of people are wrist BP monitors recommended?

*Obese patients* -this is because the wrist diameter is little affected by obesity.

______-based drug tests detect low-level, casual drug use, whereas ______-based drug tests detect longer-term (chronic) use.

*Urine*-based drug tests detect low-level, casual drug use, whereas *hair*-based drug tests detect longer-term use.

*Usage Guidelines for Basal Thermometer Fertility Tests* 1. Read and follow the instructions 2. Use ____ method(s) consistently 3. Take temperature the _____ time each morning 4. Take temp just before rising and after at least ___ hours of sleep

*Usage Guidelines for Basal Thermometer Fertility Tests* 1. Read and follow the instructions 2. Use *one* method consistently 3. Take temperature the *same* time each morning 4. Just before rising after at least *5* hours of sleep

*User Guidelines for Toilet Test Products (EZ-Detect & Early Detect Colorectal)* 1. Remove toilet tank cleansers or deodorizers, and flush toilet _____ before testing. 2. What should be done before testing? 3. Immediately after a bowel movement, place a pad in the toilet bowl, printed side up. After ___ minutes, check for the appearance of a blue cross on the test pad (positive result). 4. If color changes differ from the blue cross, what should you do? 5A. After one test has been performed, you should repeat the test on the next ____ bowel movements. 5B. If results are ______ for all _____ tests, use the remaining pad to perform a quality check of the test pads using the positive control chemical package that is provided. Flush the toilet and empty the contents of the package into the bowl as it refills. Float the remaining test pad in the water, printed side up. After 2 minutes, check for a blue cross, which indicates the test pads are working properly. If the blue cross does not appear, call the product manufacturer's assistance line provided with the product.

*User Guidelines for Toilet Test Products (EZ-Detect & Early Detect Colorectal)* 1. Remove toilet tank cleansers or deodorizers, and flush toilet *twice* before testing. 2. *Before testing, use one test pad to perform a water quality check*. If any trace of blue appears in the cross-shaped area when the pad is placed in the toilet water, *use another toilet to complete the testing*. Perform this water quality check on the second toilet as well. 3. Immediately after a bowel movement, place a pad in the toilet bowl, printed side up. After *2* minutes, check for the appearance of a blue cross on the test pad (positive result). 4. If color changes differ from the blue cross, *discard the pad and repeat the test after the next bowel movement*. 5A. After one test has been performed, you should repeat the test on the next *two* bowel movements. 5B. If results are *negative* for all *three* tests, use the remaining pad to perform a quality check of the test pads using the positive control chemical package that is provided. Flush the toilet and empty the contents of the package into the bowl as it refills. Float the remaining test pad in the water, printed side up. After 2 minutes, check for a blue cross, which indicates the test pads are working properly. If the blue cross does not appear, call the product manufacturer's assistance line provided with the product.

What do home prego tests detect in the urine?

*hCG* (human chorionic gonadotropin) -produced by the placenta following implantation

What do Fecal Occult Blood Tests detect?

*hemoglobin* The appearance of a blue-green color indicates a positive test result.

What types of medications can cause false-positive drug test results?

-*Cough medications* that contain *codeine* or *dextromethorphan* -*decongestants* -*antidiarrheals* -*narcotic analgesics* ...and possibly poppy seeds

When should a patient contact a provider in regards to results from a UTI home test kit?

-Contact a health care provider immediately for evaluation and treatment of any positive test. -If the test is negative but symptoms persist, see a health care provider immediately for evaluation and treatment. This is because the test can only detect 90% of infections, none of which being caused by Gram-positive bacteria.

What are some risk factors for colorectal cancer?

-Family history of colorectal cancer -Intestinal polyps -Ulcerative colitis These are the types of patients that may benefit from using Fecal Occult Blood Tests because they are much less invasive and costly compared to colonoscopies. -if test is positive....Medical referral!

What are some interferences for BP measurements?

-Stress -Tobacco -Smoking -Ingestion of caffeine-containing beverages -Pseudoephedrine

What are the purposes of female fertility tests?

-To time sexual intercourse to coincide with optimal fertility -To be more aware of time of ovulation Note: These tests are *not* a reliable means of birth control.

Urine-Based Ovulation Prediction Tests reveal the LH surge via....

-a difference in color or color intensity -a digital device will display a smiley face

In order to avoid incorrect results when using home prego tests, you should wait at least _______ after the date of the expected period to perform the test.

1 week

When using a home prego test, if the test result is negative, test again in _______ if menstruation has not started.

1 week -this is why it is good to recommend the two-step test, which comes with two test strips.

It may take several months of attempting pregnancy for a fertile woman to be successful. Infertility, however, is defined as the medical inability to conceive after ______ of unsuccessful attempts.

1 year

Infertility is defined as being unsuccessful at getting pregnant after how long?

1 year -patient needs to seek provider advice if can't get pregnant in 1 year -it could take up to several months for the average couple to get pregnant, so it is important to inform the patient that they shouldn't be worried if they haven't been successful for 3 months. They can try the test for up to a year before they need seek a provider's advice.

hCG is detectable in the urine within _____ after fertilization.

1-2 weeks When patients want a recommendation on which product to purchase, you will want to ask them; -when did you have intercourse? -when was your last first day of menses? --this is because every test has different sensitivity.

Blood pressure is measured indirectly by two methods:

1. *Auscultatory* (measurement of *sound*) 2. *Oscillometric* (measurement of *vibration*)

What are the three categories of blood pressure monitors?

1. *Mercury column* meter -uses the *auscultatory* method (measurement of *sound*) 2. *Aneroid* meter -uses the *auscultatory* method (measurement of *sound*) -the most common one in doctor offices 3. *Digital* meter -uses the *oscillometric* method (measurement of *vibration*)

What are the 3 types of female fertility tests?

1. Basal thermometers 2. Ovulation detection devices 3. Urine tests -the urine test is similar to the prego test except it has to be done more frequently in order to get your cycle right

1. Do not use _________ products or drink ________-containing beverages for at least 30 minutes before taking a BP measurement. These activities can increase blood pressure. 2. Wait 10-15 minutes after a ______ and 30 minutes after _______ to take a BP measurement. These activities can lower blood pressure.

1. Do not use *tobacco* products or drink *caffeine*-containing beverages for at least 30 minutes before taking a BP measurement. These activities can increase blood pressure. 2. Wait 10-15 minutes after a *bath* and 30 minutes after *eating* to take a BP measurement. These activities can lower blood pressure.

What types of interferences can cause false-positive results when using UTI test kits?

1. Dyes or medications such as phenazopyridine -These may cause a false-positive result by changing the sensor pad to pink. 2. Menses

What are the two primary uses for UTI tests?

1. Early detection of an infection in patients with a history of recurrent UTIs or risk factors associated with UTIs 2. Confirmation that an infection has been cured by antibiotic therapy.

Vitamin C interferes with which two home testing devices?

1. Fecal Occult Blood Tests -ingestion in excess of 250 mg/day may interfere with the peroxidase action of hemoglobin, causing false-negative results. 2. UTI test kits -ingestion in excess of 250 mg/day may interfere with the detection of nitrites. -Doses of vitamin C in excess of 500 mg within 24 hours of testing may result in a false-negative result for the LE (leukocyte esterase) test by blocking the development of the color reaction.

*User Guidelines for the Clearblue Easy Fertility Monitor Kit* 1. For the first month, begin testing on the ____ day after menstruation starts, and continue testing once daily for approximately _____ days in order to get the baseline hormone levels. 2. When should you start testing during the subsequent months?

1. For the first month, begin testing on the *sixth* day after menstruation starts, and continue testing once daily for approximately *10-20* days in order to get the baseline hormone levels. 2. The test will tell you when to test based on the results from the first month. Other guidelines: -Remove test stick from packaging *just before use* -Hold the test stick in the urine stream; insert stick in monitor -Discard test stick after use

What are the three methods for using urine-based prego tests?

1. Hold test stick in the urine stream for designated time (most common) 2. Urinate into testing well of test cassette 3. Collect urine in a collection cup and dip the strip in the urine

What types of interferences can cause false-negative results when using UTI test kits?

1. Strict vegetarian diet (no nitrates) 2. Tetracycline 3. Vitamin C -ascorbic acid blocks the nitrite test reaction. -The patient should allow 10 hours between the last dose of vitamin C and the test procedure.

Why is it recommended that patients test their blood pressure at home?

1. To distinguish sustained hypertension from "white-coat hypertension" 2. To assess response to antihypertensive medication 3. To improve patient adherence to treatment -Patient education and empowerment play a large role in improving patient adherence with antihypertensive efforts. -Home blood pressure monitoring gives patients a sense of control over their health and allows them to measure their progress toward a target blood pressure.

What are the three types of Fecal Occult Blood Tests available OTC?

1. Toilet tests 2. Manual stool application devices 3. Collection kits that are sent to a laboratory

For the Home Access HIV Test, the blood sample must be sent to the laboratory within ___ days of sampling.

10

A test sensitivity for hCG of ________ is needed to detect 95% of pregnancies on the expected day of a missed period.

12.4 mIU/mL

*User Guidelines for the Wristwatch Ovulation Prediction Device* Do not miss more than ___ days wearing the watch

2

How long after the LH surge will a woman typically ovulate?

24-48 hours

Colorectal Cancer is the ___ leading cause of cancer death in the U.S.

2nd Rectal bleeding is an early and common symptom of colorectal cancer, but it is not the only symptom of this cancer. -A Fecal Occult Blood Test may be beneficial to detecting this type of cancer early. However, always remember that home tests are used for screening, NOT diagnosing.

For UTI test kits, after applying the urine to the strip, the patient should wait the indicated time (~30-60 seconds) to read the color change. They should wait no longer than ___ minutes to read the test strip, and should ignore any color changes that occur after that time.

3

For the UTI test kits, the patient should administer the test on _____ consecutive days if the test on the previous day was negative.

3 Wait the indicated time (30-60 seconds), then compare the color on the sensor pad with the color chart provided. Wait no longer than 3 minutes to read the test strip, and ignore any color changes that occur after that time.

Ovulation prediction products should not be used for more than ______. If conception does not occur within this period, the woman should see a health care provider.

3 months

Do not use tobacco products or drink caffeine-containing beverages for at least _______ before taking a BP measurement. These activities can increase blood pressure.

30 minutes

The Wristwatch Ovulation Prediction Device can detect fertility up to ___ days prior to ovulation.

4

*User Guidelines for the Wristwatch Ovulation Prediction Device* Wear device while sleeping for at least ___ hours

6

What is the highest sensitivity a prego test can have on the first day of a missed menses?

90%

Drug use over a ______ period can be determined from a hair sample of 1 1/2 inches.

90-day

What is the highest sensitivity a pregnancy test can have?

97% is the max! Even if a test says on the box that it has up to 99% sensitivity, it really doesn't. -in fact a lot of these tests will even advertise that they can test for pregnancy up to *2 days before* the first day of menses, however, even on the first day of missed menses the max sensitivity is only 90%.

What days in the cycle are the best time for fertilization?

About 2 days before ovulation, the day of ovulation, and the day after ovulation. This is because: -the ovum is only good for 12-24 hours -sperm is only good for 72 hours

How can you help a patient make sure that their digital device is correctly calibrated?

After they purchase the device you can have them measure their BP with their device in front of you, and then you can measure their BP manually and compare the readings to make sure the device is working properly. It is very important that you make sure the BP device is correctly calibrated before you send the patient out of the pharmacy.

*Fecal Occult Blood Tests* Blood may be present on the surface or contained within the stool matrix. In general, matrix blood originates in the _____ GI tract, whereas surface blood comes from the ____ GI tract. FOBT kits are more likely to detect blood from _______ (higher or lower?) GI abnormalities.

Blood may be present on the surface or contained within the stool matrix. In general, matrix blood originates in the *upper* GI tract, whereas surface blood comes from the *lower* GI tract. FOBT kits are more likely to detect blood from *lower* GI abnormalities. *Toilet tests* -The toilet tests use a reagent that is sandwiched between two layers of biodegradable paper. -These tests are placed in the toilet bowl after a bowel movement. -This type of kit is based on the premise that *a significant amount of fecal blood from stool will remain on the surface of the toilet bowl water after a bowel movement*. *Manual stool application devices* -With the stool application device tests, a wooden stick is used to apply stool to two pads or wells. -For these tests, the patient should attempt to *obtain samples of both surface and inner stool*.

Blood pressure readings include two types of pressures: ________, which indicates pressure at the time of contraction of the heart cavities, and ___________, which indicates pressure at the time of dilation of the heart cavities.

Blood pressure readings include two types of pressures: *systolic*, which indicates pressure at the time of contraction of the heart cavities, and *diastolic*, which indicates pressure at the time of dilation of the heart cavities.

What is the minimum temperature that urine needs to be at in order to avoid incorrect results when using home prego tests?

room temp -Warm refrigerated sample to room temperature for 20-30 minutes before testing

Chloride ions surge approximately _____ before ovulation

Chloride ions surge approximately *5 days* before ovulation

*User Guidelines for the Wristwatch Ovulation Prediction Device* How often should the device be cleaned?

Clean sensor at beginning of each cycle -Do not get device wet

Which Urine-Based Ovulation Prediction Test product should you recommend to patients?

Clearblue Easy Fertility Monitor Kit

What type of Fecal Occult Blood Test is most often recommended by PCPs to their patients?

Collection kits that are sent to a laboratory

What type of BP device will patients most likely use to take their BP?

Digital, automatic -because it requires less training One disadvantage to using these devices is that there is no way for the patient to know if their device is out of calibration. With the manual, aneroid meter, if the needle is not registering all the way down to zero, then you know that it is out of calibration.

What is the purpose of drug abuse tests?

Drug abuse tests may allow parents and caregivers to detect drug use early enough to affect the course of addiction. Home drug tests are marketed primarily to parents as an aid for determining drug use in their children. These tests are a means of obtaining results anonymously when drug use is suspected. Home drug testing, however, is not a substitute for open communication between parents and children regarding drug use.

What organization is involved in the regulation of home testing products?

FDA

True or False: Implantation will always occur before the expected onset of the next menses cycle.

False Implantation does not necessarily occur before the expected onset of the next menses

True or False: Fecal Occult Blood Tests are specifically used for the detection of colorectal cancer.

False It tests for the presence of blood in the stool, which can occur due to many different conditions and circumstances.

True or False: The Wristwatch Ovulation Prediction Device is the most expensive, but it is also the most accurate method for detecting ovulation.

False Its accuracy is equivalent to the other products that measure LH.

True or False: Prego tests don't have an expiration date.

False Patients need to check the packaging for the expiration date before the use the test.

True or False: The basis for the basal thermometer as a fertility testing device is due to a subtle change in body temperature that occurs from the beginning of the cycle to ovulation, in which a drop in temperature signals that ovulation has occurred.

False a *rise* in temperature signals that ovulation has occurred.

________ BP monitors have so far been found to be inaccurate and are not recommended.

Finger

When is the best time to use a basal thermometer fertility test?

First thing in the morning before you do anything (can't drink water, or even get out of bed to use the restroom)

When using a home prego test, if the test result is positive, what should they do?

Follow up with their PCP and get an OBGYN.

When using a home prego test, if a patient gets a negative test result for the second time (a week after their first negative result) and their menstruation has still not started, what should they do?

Follow up with their PCP and possibly get an OBGYN.

Since the change in body temp is so small and subtle, you should recommend a basal thermometer that has what feature for interpreting results?

Graphically plotted measurements.

Home test kits that require ______ or _______ samples for HIV detection are currently available.

Home test kits that require *saliva* or *blood* samples for HIV detection are currently available. Blood samples: Home Access HIV Test Saliva: OraQuick

Home urine tests detect drug use that occurred from when to when?

Home urine tests detect drug use that occurred from *several hours before testing to within 2-3 days of testing*. The amount of drug found in the urine is affected by: -the time since consumption -the amount taken -the amount of water consumed before sampling

What are home pregnancy test sensitivity levels based on?

How much hCG is needed in the urine in order to detect pregnancy.

Hypertension is defined as either a systolic blood pressure greater than _______ mmHg or a diastolic blood pressure greater than _____ mmHg.

Hypertension is defined as either a systolic blood pressure greater than *140* mmHg or a diastolic blood pressure greater than *90* mmHg. Note: hypertension is often an *asymptomatic* disease. - a significant factor for the lack of adequate BP control is the lack of patient motivation to take steps to control blood pressure, especially if the patient is asymptomatic, which leads to nonadherence with treatment strategies.

How is a positive test result indicated for the urine-based drug tests?

In each urine test, a positive result for a particular drug is the *absence of a line* next to the drug name in the testing area. -however there will be a line present in the control area. *For a negative test, a line appears by the drug name and in the control area.*

What does the Clearblue Advanced Digital Test (a Urine-Based Ovulation Prediction Test) measure in the urine to determine ovulation?

It measure both *LH* and *estrone-3-glucuronide (E3G)* -E3G is a component of estrogen -by testing for two hormones, it increases both sensitivity and specificity. Recall from biostats that: -Sensitivity = the probability of a positive test result given the presence of the disease (or in this case, the hormone) -Specificity = the probability of a negative test result given the absence of the hormone.

Why is the Clearblue Advanced Digital Test (a Urine-Based Ovulation Prediction Test) the best choice for recommending to patients?

It measure both LH and estrone-3-glucuronide (E3G), which increases the sensitivity and the specificity of the test.

How does the Wristwatch Ovulation Prediction Device work to detect ovulation?

It uses a specialized biosensor to transdermally detect and measure the *fluctuation of chloride ions* to predict ovulation Chloride ions surge approximately *5 days* before ovulation

Why is the accuracy and accessibility of home pregnancy tests so important?

It's important that our patients are able to detect their pregnancy early so that they can make important decisions about how to proceed with their life. -stop drinking, smoking -stop eating certain foods -stop taking certain medications -start saving their pennies because kids be expensive -decide whether or not to keep it

Mercury column and aneroid meters involve __________ and require the use of a __________.

Mercury column and aneroid meters involve *auscultation* and require the use of a *stethoscope*.

How is a positive test result indicated for the hair-based drug tests?

Positive results are *reported as a number* indicating *low, medium, or high levels of use* for all drugs except marijuana, which is reported only as positive or negative.

Regular thermometers come in _____ gradation whereas basal thermometers come in _____ gradation.

Regular thermometers come in *0.2* gradation whereas basal thermometers come in *0.1* gradation.

If a woman doesn't use the first morning urine to test for pregnancy, what can she do to ensure that her urine is concentrated enough for testing accuracy purposes?

Restrict fluid intake for *4-6 hours* before urine collection.

_______ drug tests are available, but they are currently marketed only to drug testing programs and employers.

Saliva

Upon the discontinuation of oral contraceptives. ovulation will be delayed for....

the first 1-2 *cycles* -Therefore, if a patient has just recently stopped taking their oral contraceptives, you need to tell them to wait at least 2 cycles before administering the ovulation prediction test. -i.e. they should administer the test during the third cycle.

*User Guidelines for the Wristwatch Ovulation Prediction Device* When should the patient start wearing the device?

Start on the *first, second, or third day of the menstrual cycle*

Out of the three type of female fertility tests, which is the most simple?

The Basal thermometers

The HIV tests detect _________ to the virus. Because ___ weeks to ____ months may be required for an exposed individual to develop sufficient _________ for detection, the time of possible exposure to the virus must be considered in determining when to perform the test.

The HIV tests detect *antibodies* to the virus. Because *3* weeks to *6* months may be required for an exposed individual to develop sufficient *antibodies* for detection, the time of possible exposure to the virus must be considered in determining when to perform the test.

How are the digital devices for the Urine-Based Ovulation Prediction Tests different from the non-digital ones? (besides showing a smiley face instead of a color change)

The digital devices require testing the urine consistently for the first month in order to determine the individual patient's baseline of LH levels. This is so the test can compare the LH levels to the patient's baseline instead of to a control, thereby increasing the accuracy of the results.

Which type of urine is the best for using in a home prego test?

The first morning urine -it has the highest amount of hCG in it -it is the most concentrated

What is basal temperature?

The lowest body temperature we have when we are at rest (i.e. when we sleep) -this is why the temperature needs to be taken first thing in the morning before you even get out of bed. --also shouldn't drink water before testing

The mechanism of action of your typical "pee on a stick" home pregnancy test involves the detection of ________ in the urine by using enzyme immunoassay technology where the _______ binds to ________ to form a complex, which then triggers a _________ change.

The mechanism of action of your typical "pee on a stick" home pregnancy test involves the detection of *hCG* in the urine by using enzyme immunoassay technology where the *hCG* binds to *antibodies* to form a complex, which then triggers a *color* change. Note: there are some products out there that rely less on the color change factor for determination, such as: -digital products -smiley faces --these products lesson the chance for human error in interpretation (so good to recommend)

What is the primary advantage to using the OraQuick HIV Test over the Home Access HIV Test?

The saliva test (OraQuick) uses technology similar to that used in home pregnancy tests to detect antibodies to both HIV-1 and HIV-2. Therefore, *the test results are immediate*. Whereas with the Home Access HIV blood test, after collection, the blood samples are mailed to a certified laboratory for processing. -Positive samples are rescreened twice. -Repeated positive samples are confirmed with an immunofluorescent assay.

What is the accuracy rate of Fecal Occult Blood Tests?

The sensitivity of Fecal Occult Blood Tests for colorectal cancer detection varies from 13% to 50%

What type of Fecal Occult Blood Test is the easiest to use?

The toilet test

True or False: Nitrite-only UTI tests have low sensitivity but high specificity.

True

True or False: If a home pregnancy test result is positive, the woman should assume she is pregnant.

True -thus she should contact her health care provider as soon as possible

True or False: The use of oral contraceptives does not interfere with the results of a pregnancy test.

True However, it does interfere with Ovulation Prediction Tests

Why is a strict vegetarian diet a reason for interference with a UTI test?

UTI test kits detect nitrites because Gram-negative bacteria convert nitrates into nitrites. Strict vegetarians do not have nitrates in their diet, so the E. coli will not produce the nitrites.

Whether a pregnancy test is appropriate for the patient should be determined first by asking questions about her _________ and the number of days since ___________. If product use is appropriate, the patient should be asked about previous use of ___________ and any difficulties the patient had with them. Questions about ____________ and medication use should also be asked to determine whether inaccurate test results are possible or whether special measures may be required to protect the unborn child.

Whether a pregnancy test is appropriate for the patient should be determined first by asking questions about her *menstrual cycle* and the number of days since *intercourse*. If product use is appropriate, the patient should be asked about previous use of *pregnancy tests* and any difficulties the patient had with the tests. Questions about *medical disorders* and medication use should also be asked to determine whether inaccurate test results are possible or whether special measures may be required to protect the unborn child.

Your basal temperature can be taken orally, ___, or ______.

Your basal temperature can be taken orally, *rectally*, or *vaginally*. However, you must pick one way and stick with it for consistency.

For Urine-Based Ovulation Prediction Tests, a digital device reveals the LH surge via....

a smiley face -this means that LH has been detected and a woman's chance for conceiving are increased over the next 48 hours. --may also tell you whether you have a high chance, a medium chance, or a low chance of getting pregnant. Note: The digital devices require testing the urine consistently for the first month in order to determine the individual patient's baseline of LH levels. This is so the test can compare the LH levels to the patient's baseline instead of to a control, thereby increasing the accuracy of the results.

Urine-Based Ovulation Prediction Tests are based on the detection of....

a surge in *LH*

Usage of the appropriate sized BP cuff is important because a cuff that is too small can lead to...

an overestimation of the BP.

For Urine-Based Ovulation Prediction Tests, the ___________ is directly proportional to the amount of LH in the urine sample.

color intensity Note: comparing colors and color intensity can be difficult and very subjective, so it is probably better to recommend the digital device, which tells you whether you have a high chance, a medium chance, or a low chance of getting pregnant.

When does the LH surge begin?

day 10-12 in the cycle (a couple days before ovulation--the 14th day)

when does ovulation occur?

day 14

Oscillometric sensors are often used with ______ meters.

digital

The earlier a pregnancy test is used, the greater the likelihood of a ________ result.

false-negative

For any urine test, the ________ urine is the best for testing.

first morning -for later testing, use urine held in the bladder for at least 4 hours.

The basis for the basal thermometer as a fertility testing device is due to a subtle change in body temperature that occurs when?

from the beginning of the cycle to ovulation. -this gives you an idea for when you ovulate during your cycle and lets you time your intercourse for the optimal chance of pregnancy.

UTI test kits test for Gram-_____ bacteria.

negative Gram-negative bacterium Escherichia coli is responsible for 80% of UTIs Note: the sensitivity is not 100% because it only tests for gram-negatives.

UTI test kits detect ____ and/or proteins in the urine.

nitrites Gram-negative bacteria convert nitrates into nitrites.

*Fecal Occult Blood Tests* Because bleeding from cancerous lesions may be intermittent, perform the test on ______ consecutive bowel movements to increase the chance of detecting a possible lesion.

three