Fundal check post BTL

[JaneyW]

I am the first to admit that I don't know everything, but I have been doing this a while and I also teach it, so I know quite a lot. Anyway, today I heard from my students that they have been told not to do fundal checks on pts who have had a c/s with BTL. Have any of you heard of/practice this? If so, why? Is there a physiologic reason not to do this? I have never heard of this, but I am open to learn. Thanks!

[klone, MSN, RN]

Nope. If there was recently a baby in there, you need to do fundal checks, period.

[JaneyW]

Klone, that was my thought. The risk of bleeding would trump most other contraindications. But I learn new things all of the time, so I thought I'd put it out here.

[TriceRN]

I've never heard of that either JaneyW.

I wonder how many aren't doing fundal checks after BTLs. I'd much rather my patient be a little more uncomfortable temporarily than not check at all and there be more serious complications and consequences.

So, their instructors are teaching them this? (I'm assuming since you said student)

[JaneyW]

No, chocolatrice, I am their instructor and the staff nurses were telling them this. I didn't have time to ask them why. I will next time we are there. I thought I'd throw it our here and see what people had to say.

[TriceRN]

Oh I'm sorry. I thought you were the nurse on the floor and they were working with you! I thought maybe it was something new that was being taught in nursing school or something.

Wow, when you ask, please come back and let us know if you have time. I'm very interested in knowing what that is all about.

[rn/writer, RN]

I work postpartum and have never heard this either. I would certainly be gentle, as I am with all my section patients, but skipping the fundal check doesn't sound like safe practice.

The only time I have been told to skip a fundal check was with a patient who had a partially ruptured uterus, and that made sense. I watched that one very closely via other measures--v/s, pain rating, bleeding checks after activity, etc.

[littlemammanurse, BSN, RN]

I did my pregrad placement on a Post Partum floor and we were taught in school to always check the fundal height even if it was a c/s patient.I always checked them as I was taught to do.

[Elvish, BSN, DNP, RN, NP]

Nope, never heard of it. We treat our post-BTL C/S ladies like any other section. Not sure why a BTL would change the game any.

[serenity1]

We have a dr. on staff that writes on the dressing "NO FUNDAL CHECKS". He's the only one. We do fundal checks on all btl patients except his. Not sure why--makes no sense.