Quote:
Originally Posted by Pat Answers
....Medicare approved it. Of course, they will order stuff as often as they can, as long as someone will pay for it....
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Translation: "I can get paid for it and it also helps in legal defense when you sue me if I've done it more frequently."
Once a yr routine blood work is good enough for screening. Some conditions require more frequent, specific testing: BS in DM, BUN/Cr in renal failure, LFT in liver failure, blood counts in anemia or certain treatments for ca etc, 'lytes when using diuretics-- frequency depending on troubles they've caused in a given pt.
BS & triglyceride levels are the only two tests that are significantly affected by the fasting vs fed state before the blood draw (and we can argue that a 2hrpp test is better for BS screening).
Re: dehydration, drinking water & BUN levels-- we lose ~1.5L of water /day in urine, sweat, breathing, BMs. (More when exercising/working & sweating.)...Obviously, it needs to be replaced on a daily basis. Animals & plants (ie-food) are about 70% water on average, so we can get almost all the water we need just by eating.
A given pt will have a slightly higher BUN when relatively dehydrated compered to his level when well hydrated---so, unless you have his baseline, well hydrated level on file for comparison, a single, isolated test is meaningless.---More importantly, if your doc needs a BUN test to see if you're dehydrated when you appear in the ER with dry tongue, wrinkled skin and a history of diarrhea and vomiting for 2 days, maybe you should get a new doc (better-- an
old doc).