Helicobacter Pylori Antibody
Helicobacter Pylori Antibody
Common use
Specimen
Serum (1 mL) collected in a plain gold-, red-, or red/gray-top tube. Place separated serum into a standard transport tube within 2 h of collection.Normal findings
Description
The urea breath test is an accurate way to identify the presence of H. pylori. For the urea breath test, the patient swallows a capsule containing urea made from an isotope of carbon. If H. pylori is present in the stomach, the bacteria will metabolize the urea and isotope labeled carbon dioxide will be released. The carbon dioxide is absorbed by the stomach tissue, passes into the blood where it travels to the lungs, and is excreted during respiration. Samples of exhaled breath are collected 10–15 minutes after the capsule has been ingested, and the presence of isotope labeled carbon in the exhaled carbon dioxide is measured. If the isotope is present, H. pylori is present in the stomach. When the organism has been effectively treated with antibiotics, the test changes from positive to negative.
A stool antigen test may be used to identify the presence of H. pylori. This is an accurate test and may be requested for patients who are unable to cooperate for the urea breath test.
Examination of tissue biopsy, obtained by endoscopy, from the lining of the stomach is another way to identify the presence of H. pylori. The sample is tested for urease activity and is histologically examined for the presence of inflammatory epithelial cells in the presence of the characteristically curve shaped H. pylori bacteria.
This procedure is contraindicated for
- N/A
Indications
- Assist in differentiating between H. pylori infection and NSAID use as the cause of gastritis or peptic or duodenal ulcer
- Assist in establishing a diagnosis of gastritis, gastric carcinoma, or peptic or duodenal ulcer
Potential diagnosis
Positive findings in:
- H. pylori infection
- H. pylori colonization
Critical findings
- N/A
Interfering factors
- N/A
Nursing Implications and Procedure
Potential nursing problems
| Problem | Signs & Symptoms | Interventions |
|---|---|---|
| Infection (Related to fecal matter–contaminated food or water) | Dark- or tar-colored stools; bloating; abdominal pain; feeling full after eating a small meal; lack of appetite; nausea and vomiting; development of stomach cancer | Administer prescribed proton pump inhibitors; administer prescribed antibiotics; avoid alcoholic beverages |
| Pain (Related to gastric irritation; gastric inflammation) | Abdominal cramping; abdominal distention; report of pain; emotional symptoms of distress; crying; agitation; facial grimace; moaning; verbalization of pain; irritability; disturbed sleep; altered blood pressure and heart rate; nausea; vomiting | Collaborate with the patient and physician to identify the best pain management modality to provide relief; refrain from activities that may aggravate pain; monitor pain severity; administer prescribed proton pump inhibitors; administer prescribed antibiotics; administer H2 receptor antagonists; administer prescribed antacids |
| Nutrition (Related to nausea and vomiting; alcohol use; diarrhea; gastrointestinal bleed; abdominal pain) | Known inadequate caloric intake; weight loss; muscle wasting in arms and legs; skin that is flaky with loss of elasticity; inadequate absorption of iron, vitamins, and minerals | Document food intake with possible calorie count; assess barriers to eating; consider using a food diary; monitor daily weight; arrange dietary consult with assessment of cultural food selections; encourage limitation of coffee and other caffeinated beverages; discuss refraining from excessive alcohol use |
| Fatigue (Related to bleeding; pain; inadequate nutrition; nausea; vomiting) | Decreased concentration; increased physical complaints; inability to restore energy with sleep; reports being tired; inability to maintain normal routine; decreasing HGB/HCT; nausea; vomiting; inadequate dietary intake; self-report of abdominal pain | Assess for physical cause of fatigue; pace activities to preserve energy stores; rate fatigue on a numeric scale to trend degree of fatigue over time; identify what aggravates and decreases fatigue; assess for related emotional factors such as depression; evaluate current medications in relation to fatigue; assess for physiologic factors such as anemia; monitor for black tarry stools that are indicative of bleeding; administer prescribed blood or blood products; administer prescribed antiemetic and antidiarrheal medication; monitor and trend HGB/HCT |
Pretest
- Positively identify the patient using at least two unique identifiers before providing care, treatment, or services.
- Inform the patient that the test is used to assist in the diagnosis of H. pylori infection in patients with duodenal and gastric disease.
- Obtain a history of the patient’s complaints, including a list of known allergens, especially allergies or sensitivities to latex.
- Obtain a history of the patient’s gastrointestinal system, symptoms, and results of previously performed laboratory tests and diagnostic and surgical procedures.
- 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). Assess for chronic use of medications known to irritate gastrointestinal (GI) tract. Information should also be collected regarding diet, use of alcohol, use of tobacco products, and any relationship between GI symptoms and timing of meals, medications, or ingestion of coffee or alcohol. Assess the patient’s level of emotional stress and inquire about factors that trigger feelings of anxiety or stress.
- 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 health-care provider (HCP), who will discuss the results with the patient.
- 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
- Provide education regarding the disease, factors that can trigger symptoms, and possible treatment options that may include surgery.
- Stress the importance of adhering to requests for follow-up visits as ordered.
- Reinforce information given by the patient’s HCP regarding further testing, treatment, or referral to another HCP.
- Inform the patient that a positive test result constitutes an independent risk factor for gastric cancer.
- Answer any questions or address any concerns voiced by the patient or family.
Expected Patient Outcomes
- Knowledge
- States the importance of taking prescribed antibiotics until completed to ensure infection is resolved
- States the importance of taking prescribed medications to manage infection and decrease pain
- Skills
- Demonstrates proficient use of guided imagery and relaxation techniques to assist with pain management
- Identifies foods that cause gastric distress and develops a plan to avoid those foods
- Attitude
- Complies with the request to abstain from excessive alcohol use
- Complies with the request to refrain from eating foods that cause gastric irritation
Related Monographs
- Related tests include capsule endoscopy, EGD, gastric acid stimulation, gastric emptying scan, gastrin, and upper GI series.
- Refer to the Gastrointestinal System table at the end of the book for related test by body system.