Question

LEARNING APPLICATION Critical Thinking **

1/ A patient asks you to recommend a laboratory for the tests ordered by the provider. How will you respond to the request? What are some factors that will influence your response?

2. A patient performed a pregnancy test at home, but her provider has requested a pregnancy test at the clinic. How will you explain to the patient why the home test may not be as accurate as the test performed at the clinic?

Answer 1

1. Factors to be considered while selecting a laboratory

Insurance Plan coverage

Refer patient's health insurance plans for it's coverage details because most of the lab tests are expensive

Many insurance plans provide choice to patients , but in HMOs plans ( Health Maintenance Organisation)are limited

Lab accreditiation

60-70% of decisions regarding patient's diagnosis and treatment, hospital admission and discharge are based on laboratory test results. The labs accredited with College of American pathologists, their accreditation covers the entire spectrum of laboratory test disciplines with the most scientifically customised checklist requirements. Also check for CLIA (Clinical Laboratory Improvement Amendment) licensure for the laboratory

Convenience

Pick a location which is not so far from the home. If the client wants to do the tests regularly, choose a lab near to the office. Making time for lab tests is difficult enough without logistic problems

Waiting period

Waiting too long is stressful. Make sure the lab has an online portal that post lab results.

2. Home pregnancy test only detect whether Human Chorionic Gonadotropin (HCG) is present in the urine or not. The value for healthy pregnancy cannot be rule out by home pregnancy test. Home pregnancy test will detect  the HCG value 25mlU/mL of  HCG in urine sample. The value of HCG corresponding to weeks of gestation is the accurate method to confirm healthy pregnancy. This can only be done using blood test. In case of ectopic pregnancies and missed abortions, HCG will be low corresponding to the gestational age . On the other hand , high values are seen in molar pregnancy or hydatidform mole ( a rare complication of pregnancy characterised by abnormal growth of trophoblasts)