On postpartum day 1, which finding would be a sign of a potential complication?

• A. Deep tendon reflexes 4+.
• B. Normal blood pressure.
• C. Heart rate 60/min.
• D. Afebrile.

Answer: (A)

Hyperreflexia, or very active deep tendon reflexes (4+), signals CNS irritability that can accompany postpartum hypertensive disorders like preeclampsia. Normal reflexes are about 2+, so a 4+ finding on the first postpartum day is not normal and prompts further assessment of blood pressure and associated symptoms (headache, vision changes, epigastric pain) and appropriate monitoring or treatment to prevent progression. Be mindful that magnesium sulfate toxicity typically decreases reflexes, so this finding points to potential complication rather than toxicity. The other options—normal blood pressure, heart rate of 60, and afebrile—do not by themselves indicate a postpartum complication and would not raise the same concern for CNS involvement.