Questions about Clonus

[bam_bam]

Do you check for clonus when doing a preeclamptic assessment? Where I first started L&D, it wasn't done and I had no idea what it was. When I was a traveler I had to ask someone about it because they always did check. Is this common that some places don't assess clonus? Also what is the significance of positive clonus? Does it mean that the preeclampsia is worse, are they more at risk to seize??

TIA

[SmilingBluEyes]

We always assess presence or lack of clonus in the whole assessment of woman at risk for preeclampsia/eclampsia. It's surely simple enough, and is part of the whole assessment. If a person is positive for clonus, there is sufficient nervous system excitability to indicate possible and real risk of seizure (eclampsia) ---it's as simple as that. Its presence along with others symptoms, such as epigastric pain, elevated liver enzymes, proteinuria, and elevated blood pressures, facial and extremity edema and vision disturbances---- definately warrants treatment and seizure precautions be taken asap. I have never worked anywhere presence of clonus was NOT assessed in the over assessment of all new admits in labor/delivery. It's so simple, I can't imagine why NOT.

[Nurse_Educator]

Smiling Blue Eyes gave you a wonderful answer. We also always check for clonus when we do a preeclamptic assessment. The nurses check patellar, and usually biceps reflex as well as for clonus. It's a good baseline to have, especially if you need to start Mag.

Marilyn

[RNmommy]

I'm in PP and we check EVERY pt for clonus q shift, PIH pts get checked q 4h.

[rnmi2004]

The OB unit I'm doing this clinical rotation on has DTR & clonus checks as part of every mom's shift assessment.