Postpartum Assessment: clonus, reflexes, PreE screening

[obrnco]

During my orientation my preceptor told me to include patellar reflexes and to check for clonus with each patient assessment including re-assessments. She also said to be asking about preeclampsia s/s with each assessment ie headache, vision changes, any increases in swelling, RUQ pain ect.

I've noticed other nurses assess these in patients who have a history of preeclampsia, patient's with BP's that are running higher or if they are on mag but not on patients with a perfectly healthy pregnancy. What do you guys do? Our policy doesn't include these factors into an assessment for patients with a typical pregnancy but I want to make sure I am doing what's best for my patients. I don't want to be leaving out these assessments if I should be doing them but I also don't want to be waking my patients up in the middle of the night using the hammer ect if it is completely unnecessary.

Thank you so much for your input!

[AZBlueBell]

5 hours ago, obrnco said:

During my orientation my preceptor told me to include patellar reflexes and to check for clonus with each patient assessment including re-assessments. She also said to be asking about preeclampsia s/s with each assessment ie headache, vision changes, any increases in swelling, RUQ pain ect.

I've noticed other nurses assess these in patients who have a history of preeclampsia, patient's with BP's that are running higher or if they are on mag but not on patients with a perfectly healthy pregnancy. What do you guys do? Our policy doesn't include these factors into an assessment for patients with a typical pregnancy but I want to make sure I am doing what's best for my patients. I don't want to be leaving out these assessments if I should be doing them but I also don't want to be waking my patients up in the middle of the night using the hammer ect if it is completely unnecessary.

Thank you so much for your input!

I check for all that if there is cause for it. If their BP is normal and no risk factors with their pregnancy, I don’t. I do check clonus with every pt/assessment. My preceptor did too and now it’s just habit for me.

if the pt is on mag, they have more frequent assessments let our policy and I do check for everything including reflexes, clonus, Lung sounds, vision changes, RUQ pain etc. if I have to wake them to do so, I have to wake them. But it’s important. And typically, there’s something else I have to be in their room for and I can cluster my care to limit their wake ups .

[jodyangel, RN]

So do you only check reflexes ect on your initial assessment. I’m not sure if your pt is there for let’s say a Previn....why you would do these checks q 4 hrs?

[LaborRN]

On ‎6‎/‎20‎/‎2020 at 12:26 PM, jodyangel said:

So do you only check reflexes ect on your initial assessment. I’m not sure if your pt is there for let’s say a Previn....why you would do these checks q 4 hrs?

What is a previn?

[jodyangel, RN]

error in typing. I meant to type Previa.