OB question!! Help please!

[EternalFeather]

After delivery of placenta, mother has pulse:90, fundus is firm & midline, & 110/60 BP, isnt that hypotension?

So do we put the woman in left side or just continue to monitor? cause i learned that the reposition to left side only helps with venacaval syndrome. she doesnt have uterus pressure on the vessel anymore...

another option is to monitor vital signs every hour, but isnt that too long?

help please!

[Esme12, ASN, BSN, RN]

What is the exact question...No 110/60 is NOT hypotension.

What is venacaval syndrome?

[suzw]

Those vitals seem pretty normal, considering what her body has just done...

[Guest 360983]

What are you concerned about in the postpartum patient? What assessment findings are consistent with this concern? How do those assessment findings compare to the information provided in the question?

110/60 is a typical BP for a young, healthy patient, which most OB patients are.

[suzw]

I would say you do want to keep an eye on the vitals to make sure they don't trend in the wrong direction (BP falling, pulse rising) because both BP and HR are sort of borderline and we want to be watching for signs of excessive blood loss. But I would think every 2 hours should be enough if no other problems (note, I am speaking only from personal experience, my OB clinicals are NEXT quarter!)

[Summer Days]

In an uncomplicated birth process hypotension is an expected finding d/t blood loss associated with birth and additionally the body ridding itself the extra fluid it accumulated during pregnancy. But no, 110/60 is not hypotension.

[THELIVINGWORST, ASN, RN]

More concerned with lochia flow and whether symptomatic or not.

[Guest 360983]

In an uncomplicated birth process hypotension is an expected finding d/t blood loss associated with birth and additionally the body ridding itself the extra fluid it accumulated during pregnancy. But no, 110/60 is not hypotension.

I'm an ER nurse, not an OB nurse. I have a few accidental catches and several late miscarriages under my belt, however. I would be VERY concerned about hypotension in a postpartum mom as she should be able to compensate for a typical amount of blood loss. People can bleed quite a bit before they decompensate, which is why as nurses we are always looking for early signs that something is amiss.

EDIT: To me, hypotension to worry about is usually a trend downwards over time, a MAP in the low 70s (MAP of 65 is bolus and presser time) or a systolic below 90. Of course, if the patient is old and/or has underlying hypertension, I adjust upwards. I also have cardiac monitoring, vasoactive drugs and MDs at my fingertips.

[THELIVINGWORST, ASN, RN]

Most moms have low BP during the fourth stage of birth. It's normal. Actually, anything above 130/90 is worrisome during this time. Symptoms are more concerning than "classic" hypotension ranges. These moms are usually otherwise healthy.