heterophil antibody test

Infectious Mononucleosis Screen

Common use

Specimen

Normal findings

Description

This procedure is contraindicated for

N/A

Indications

• Assist in confirming infectious mononucleosis

Potential diagnosis

Positive findings in:

• Infectious mononucleosis

Critical findings

N/A

Interfering factors

• False-positive results may occur in the presence of narcotic addiction, serum sickness, lymphomas, hepatitis, leukemia, cancer of the pancreas, and phenytoin therapy.
• A false-negative result may occur if treatment was begun before antibodies developed or if the test was done less than 6 days after exposure to the virus.

Nursing Implications and Procedure

Potential nursing problems

Pretest

• Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
• Patient Teaching: Inform the patient this test can assist with diagnosing a mononucleosis infection.
• Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex. Obtain a history of exposure.
• Obtain a history of the patient’s hepatobiliary and immune systems, symptoms, and results of previously performed laboratory tests and diagnostic and surgical procedures.
• Note any recent therapies that can interfere with test results.
• Obtain a list of the patient’s current medications, including herbs, nutritional supplements, and nutraceuticals (see Effects of Natural Products on Laboratory Values online at DavisPlus).
• Review the procedure with the patient. Inform the patient that specimen collection takes approximately 5 to 10 min. Address concerns about pain and explain that there may be some discomfort during the venipuncture.
• Sensitivity to social and cultural issues, as well as concern for modesty, is important in providing psychological support before, during, and after the procedure.
• Note that there are no food, fluid, or medication restrictions unless by medical direction.

Intratest

• Potential complications: N/A
• Avoid the use of equipment containing latex if the patient has a history of allergic reaction to latex.
• Instruct the patient to cooperate fully and to follow directions. Direct the patient to breathe normally and to avoid unnecessary movement.
• Observe standard precautions, and follow the general guidelines in Patient Preparation and Specimen Collection. Positively identify the patient, and label the appropriate specimen container with the corresponding patient demographics, initials of the person collecting the specimen, date, and time of collection. Perform a venipuncture.
• Remove the needle and apply direct pressure with dry gauze to stop bleeding. Observe/assess venipuncture site for bleeding or hematoma formation and secure gauze with adhesive bandage.
• Promptly transport the specimen to the laboratory for processing and analysis.

Post-Test

• Inform the patient that a report of the results will be made available to the requesting HCP, who will discuss the results with the patient.
• Recognize anxiety related to test results, and inform the patient that signs and symptoms of infection include fever, chills, sore throat, enlarged lymph nodes, and fatigue. Self-care while the disease runs its course include adequate fluid and nutritional intake along with sufficient rest. Activities that cause fatigue or stress should be avoided. Advise the patient to refrain from direct contact with others because the disease is transmitted through saliva.
• Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP. Advise the patient to refrain from direct contact with others because the disease is transmitted through saliva. Answer any questions or address any concerns voiced by the patient or family.
• Depending on the results of this procedure, additional testing may be performed to evaluate or monitor progression of the disease process and determine the need for a change in therapy. Evaluate test results in relation to the patient’s symptoms and other tests performed.

• Patient Education

  • Inform the patient that approximately 10% of all results are false-negative or false-positive.
  • Inform the patient that signs and symptoms of infection include fever, chills, sore throat, enlarged lymph nodes, and fatigue.
  • Emphasize the importance of self-care while the disease runs its course, which includes adequate fluid and nutritional intake along with sufficient rest.

• Expected Patient Outcomes

  • Knowledge
  • Verbalizes understanding of how to pace activities to conserve energy and manage fatigue in relation to activities of daily living
  • States the importance of lengthy rest periods for recovery from mononucleosis
  • Skills
  • Follows the recommendation to increase fluid intake (water and juice)
  • Follows the recommendation to take over-the-counter ibuprofen or acetaminophen for comfort as needed
  • Attitude
  • Complies with the request to get plenty of rest to facilitate the recovery process
  • Complies with the recommendation to avoid kissing to prevent infection of another individual with mononucleosis

Related Monographs

• Related tests include CBC with peripheral blood smear evaluation and US abdomen.
• Refer to the Hepatobiliary and Immune systems tables at the end of the book for related tests by body system.