Choosing Wisely cards Flashcards
What routine testing is required for stable patients awaiting rehab, transition, or placement?
None, unless driven by specific diagnostic suspicion
When is urea testing indicated?
When there is specific diagnostic suspicion: not routinely
When should CBC be monitored in a patient with new severe anemia (Hb <70g/L) without overt bleeding?
Daily (initially)
How often should a CBC be done for a patient with new leukocytosis, and for how long?
Daily x 3d then reassess
How often should serum lytes be evaluated in a patient with DKA (on IV insulin)?
q2-4h
For a patient on new medications/treatments associated with electrolyte abnormalities, how frequently should lytes be monitored?
Daily (initially)
For a patient with stable hyperkalemia (5.5-6.0 mmol/L) , how often should potassium levels be monitored?
Daily
How often should creatinine be monitored in a patient with sepsis?
Daily
For a patient on new nephrotoxic agents/therapies (e.g. contrast dye, diuretics, antibiotics, etc.), how often should creatinine be monitored?
Daily (initially)
How often should creatinine be monitored in a patient with acute worsening renal function?
Daily (initially)
How often should creatinine be monitored in a patient on chronic dialysis with no residual renal function?
Creatinine monitoring is not recommended, unless there is a specific diagnostic question
What should be monitored for a patient on intravenous heparin infusion?
PTT or heparin Anti-Xa levels
What should be checked once in suspected bleeding diathesis?
PTT
What should be checked before LP?
INR
What steps can you take as a medical student to reduce unnecessary tests?
Ask for clarification on tests, treatments, or procedures that you believe are unnecessary
