Do you check DTR when pt has epidural?Register Today!
- by violet_violet Aug 24, '12Do you check DTR when pt has epidural? clonus? homan's sign?
- Aug 24, '12 by Sun0408OB is not my specialty but I have cared for a few in the ICU, I check DTR if the pt is on a mag and pit gtt. We did them q4h.
- Aug 24, '12 by FyreflieNope, never in the three places I've worked. Dermatomes & bromage for epidurals. DTRs for mag sulph patients
- Aug 24, '12 by violet_violetWhat about mag pts with epidurals?
- Aug 24, '12 by monkeybugWe checked if they were on mag, but I've never heard of doing it on a pt with an epidural. What would be the point?
- Aug 24, '12 by FyreflieQuote from violet_violetWell yeah, of course but not because of the epi.What about mag pts with epidurals?
- Aug 26, '12 by bagladyrnIf the patient has an epidural you can check dtr's on the arms - tap at the inner aspect of the elbow and observe "twitch" at the thumb/hand.
- Aug 29, '12 by foodieRNI always do, but only because I maintain an uptight and anxiety ridden attention to detail (not recommended). I expect 0 reflexes. However, the other day I had a patient who had had perfect BP's her whole pregnancy, but was in labor with an epidural in place for several hours and having BP's 160/90. When I checked her DTR's at her knees I got 2+ bilaterally. No other s/s of PIH, and after delivery her BP's started going down. Stress of delivery?? Who's knows.
Never thought of checking DTRs at the elbows, though. Thanks for the tip!