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2 Parameters of Growth
1. Weight
- Most sensitive especially in low birth weight
- Weight 2x by 6 months
-
3x by 1 year
4x by 2 year
2. Height
- Increase 1 inch/month during first 6 months
-
functions:
these
apply
to
physical,
mental,
social
and
emotional
- In which the child learns from simple operations before complex function or move
from a broad general pattern of behavior to a more refined pattern.
B. Sequential involves a predictable sequence of growth and development to which the
child normally passes.
a. Locomotion
b. Language and Social skills
C. Secular refers to the worldwide trend of maturing earlier and growing larger as
compared to succeeding generations.
5. Behavior is a most comprehensive indicator of developmental status
6. Play is the universal language of a child
7. A great deal of skill and behavior is leaned by practice
8. There is an optimum time for initiation of experience or learning
9. Neonatal reflexes must be lost first before development can proceed
Persistent Primitive Infantile Reflex (suspect Cerebral Palsy)
I. D. THEORIES OF DEVELOPMENT
Development Tasks is a skill or growth responsibility arising at a particular time in the individuals
life. The successful achievement of which will provide a foundation for the accomplishments of the
future tasks.
THEORISTS
1. Sigmund Freud (1856-1939) an Austrian neurologist, Founder of psychoanalysis
AGE
1 month
1 4 months
Circular
4 8 months
8 12 months
Coordination of Secondary
Tertiary Circular Reaction
12 18 months (1 1
year)
18 24 months
B.
Preoperational
Thought
SCHEMA
Pre-conceptual
2 7 years old
AGE
2- 4 years
Intuitive
4 7 years
BEHAVIOR
- All reflexes
- Activities related to
bodies repetition of
behavior (thumb sucking)
- Activity not related to
body
- Discover object or
persons code and code
memory arises
- Anticipate familiar events
- Exhibit goal directed
behavior
- Increase sense of
separateness
- Use trial and error to
discover change of places
and events
- Code and Code invention
of new means
- Capable of space and
time perception
- Transitional phase to
operational period
BEHAVIOR
- Egocentric (unable to
view another point of
view)
- Their thinking is basically
concrete and static
- Their concept of time is
only now and their concept
of distance is only as far as
they can see
- Not yet aware of the
concept of reversibility
- Concept of animism
(inanimate object is alive)
Stage
(Level I)
1
4-7
2
Conventional
7-10
(Level II)
3
Orientation to interpersonal relations
of mutuality. Child follows rules because of a need
10-2
of social
order,
fixed
rules and
Postconventional
Older than 12
(Level III)
5
Universal
ethical
Principle
orientation.
Follows
I. E. DEVELOPMENTAL MILESTONE
PERIOD OF INFANCY
a. Play
- Solitary play
- Non interactive
- Priority is safety
- Age who appreciate teddy bears
- Attitude: proper hygiene
b. Fear
- Stranger anxiety
- Begin at 6 7 months
- Peak at 8 months
- Diminish by 9 months
c. Milestones
E.I NEONATE
- Largely reflex
- Complete head lag
- Hands fisted
- Cry without tears (due to immature larcrimal duct)
- Visual fixation of human face
1 month
- Dance reflex disappears
- Looks at mobile objects
2 months
- Holds head up when in prone
- Social smile
- Baby coos
- Cry with tears
- Closure of posterior fontanel by 2 3 months
- Head lag when pulled to a sitting position
3 months
- Holds head and chest when in prone
- Follow object past midline
- Grasp and tonic neck reflex are fading
- Hand regards (3 months)
4 months
- Turns from front to back
- Head control complete
- Bubbling sounds
- Needs space to turn
- Laugh aloud
5 months
- Roll over
- Turn both ways
- Teething rings
- Handles rattle well
- Moro reflex disappear by 4 5 months
6 months
- Reaches outs in anticipation of being picked up
- Handle bottle well
- Sits with support
- Uses palmar grasp by 6 months
- Eruption of first temporary teeth (2 lower incisors)
- Says vowel sounds Ah, ah
7 months
- Transfer objects hand to hand
- Beginning fear of stranger
- Likes objects that are good sized
8 months
- Sits with support
- Peak of stranger anxiety
- Plantar reflex disappear
9 months
- Creeps/crawl
- Needs space for creeping
- Pincer grasp reflex
- Combine two syllables Papa, Mama
- Priority: safety
10 months
- Pull self to stand
- Understand word No
- Respond to own name
- Peak a boo
- Pat a cake since they can clap
11 months
- Cruises
- Stand with assistance
12 months
- Stand alone
- Take first step
- Walk with assistance
- Drink from a cup
- Cooperate in dressing
- Says the 2 words Mama, Papa
- Toys: pots and pans, pull toy and learn nursery rhymes
E.2. TODDLER
a. Play
- Parallel (2 toddlers playing separately)
- Provide two similar toys (squawky squeeze toy)
- Waddling duck to pull, pull truck, building block and pounding peg
b. Fear
- Separation anxiety
- Do not prolong goodbye, say goodbye firmly
- 3 Phases of separation anxiety
a. Protest
b. Despair
c. Denial
c. Milestones
15 months
- Plateau stage
- Walks alone (delay in walking maybe a sign of mental retardation)
- Puts small pellets into small bottle
- Scribbles voluntarily with pencil
- Holds a spoon well
- Seat self on chair
- Creep upstairs
- Speaks 4 6 words
18 months
- Hide of possessiveness
- Bowel control achieved
- No longer rotates a spoon
- Run and jump in place
- Walk up and down stairs holding on (typically places both feet on one step before advancing)
- Able to name body part
- Speaks 7 20 words
24 months
- Can open doors by turning doorknobs
- Unscrew lids
- Walk upstairs alone by still using both feet on the same step at same time
- Daytime bladder control
- Speak 50 200 words
30 months
- 3 year old do tooth brushing with little supervision
- 2 3 year old is the right time to bring to the dentist
- Temporary teeth complete and last temporary teeth to appear is the posterior molars
- 20 deciduous teeth by age 2 years
- Can make simple lines or stroke for crosses with a pencil
- Can jump down from the stairs
- Knows full name
- Copy a circle
- Holds up fingers
36 months
- Trusting three
- Able to unbutton
- Draw a cross
- Learns how to share
- Full name and sex
- speak fluently
- Right time for bladder control (night time control)
- Able to ride a tricycle
- Speak 300 400 words
- Clues for toilet training
a. Can stand, squat and walk alone
b. Can communicate toilet needs
c. Can maintain himself dry with interval of 2 hours
d. Character Traits
- Negativistic likes to say no (it is their way to search independence)
- Limit questions and offer options
- Temper tantrums (stomping feet and screaming)
- Ignore the behavior
- Rigid ritualistic: stereotype
- Cause: mastering
- Protruded abdomen
- Cause:
- Under development of abdomen
- Unsteady gait
- Physiologic anorexia (give foods that last for a short period of time)
E.3. PRE-SCHOOL
a. Play
- Associative play, Cooperative play
- Play house
- Role playing
b. Fear
- Body mutilation or castration fear
- Dark places and witches
- Thunder and lighting
c. Milestone
4 years
- Furious four (noisy and aggressive)
- Able to button
- Copy a square
- Lace shoes
- Know the 4 basic colors
- Vocabulary of 1500 words
5 years
- Frustrating five
- Copy a triangle
- Draw a 6 part
- Imaginary playmates
- 2100 words
d. Character Traits
- Curious
- Creative
- Imaginative
- Imitative
- Why and How
e. Behavior Problems
- Telling tall tales (over imagination)
- Imaginary friends (purpose: release their anxiety and tension)
- Sibling rivalry (jealousy to a newly delivered baby)
- Bed wetting
- Baby talk
- Fetal position
- Masturbation is a sign of boredom and should divert their attention
E.4. SCHOOL AGE (7 YEARS)
a. Play
- Competitive play
- Tug o war
b. Fear
- School phobia
- To prevent phobia orient child to new environment
- Displacement from school
- Significant person is the teacher and peer of the same sex
- Loss of privacy
- Fear of death
c. Significant Development
- Prone to bone fracture (green stick fracture)
- Mature vision
d. Milestones
6 years
- Temporary teeth begins to fall
- Permanent teeth begins to appear (first molar)
- Year of constant motion
- Clumsy movement
- Recognizes all shapes
- Teacher becomes authority figure that may result to nail biting
- Beginning interest with God
7 years
- Age of assimilation
- Copy a diamond
- Enjoys teasing and play alone
- Quieting down period
8 years
- Expansive age
- Smoother movement
- Normal homosexual
Widening of hips
Deepening of voice
Development of muscles
sign)
Production of viable sperm (last sign)
- Homosexuality
- Death
- Replacement from friends
b. Significant Person
- Peer of opposite sex
c. Significant Development
- Experiences conflict between his needs for sexual satisfaction and societies expectations
- Core concern is change of body image and acceptance from the opposite sex
d. Personality Trait
- Idealistic (parent-child conflict begins)
- Rebellious
- Very conscious with body image
- Reformer
- Adventuresome
e. Problems
- Vehicular accident
- Smoking
- Alcoholism
- Drug addiction
- Pre marital sex
How
A. Removal of secretions by proper suctioning
B. Proper Suctioning of catheter
- Place babys head to side to facilitate drainage
- Suction nose first because neonates are nasal obligates
- Suction for 5 10 seconds and should be gentle and quick because prolong deep suctioning may
result to hypoxia, bradycardia (caused by vagal nerve stimulation) and laryngospasm
C. If not effective, requires effective laryngoscopy to open the airway. After deep suctioning, an
endotracheal tube can be inserted and oxygen can be administered by a positive pressure bag and
mask with 100% oxygen at 40 60 b/min.
Nursing Alerts:
- No smoking sign to prevent combustion
- Always humidify to prevent drying of mucosa
- Mask should cover nose and mouth
- Overdosage of oxygen may lead to scaring of retina which may lead to blindness called
RETROLENTAL FIBROPLASIAS (retinopathy of prematurity)
- When meconium stained never administer oxygen because pressure will force meconium to the
alveolar sac and cause atelectasis
2. Establishing extrauterine circulation
Alerts: circulation is initiated by pulmonary ventilation and is completed by cutting of cord
Foramen Ovale
APPROPRIATE
STRUCTURE
FAILURE TO
TIME OF
REMAINING
CLOSE
OBLITERATION
24 hours complete
Fossa Ovalis
by 1 year
Ductus Arteriosus
24 hours complete
Ligamentum
by 1 month
Arteriosum
Ductus Venosus
2 months
Umbilical Arteries
2 3 months
Ligamentum
Venosum
Lateral Umbilical
Umbilical Vein
2 3 months
Ligament
Inferior Iliac Artery
Lateral Umbilical
Ligament
Inferior Iliac Artery
Ligamentum Teres
(round ligament of
liver)
Patent
Arteriosus
Ductus
Alerts: Breastfeed immediately for NSD and after 4 hours for CS (Colostrum is present on the 3rd
trimester)
B. Advantage of Breastfeeding
- Very economical
- Always available
- Promotes bonding
- Helps in rapid involution
- Decrease incidence of breast cancer
- Breast fed babies has higher IQ
- It contains anti body (IgA) lactobacillus bifidus that interfere attack of pathogenic bacteria in GIT
- Contains macrophages (store in plastic container, good for 6 months when stored in freezer)
- Disadvantages of breast milk and cows milk
- Both has no iron
- Possibility of transfer of HIV, Hepatitis B
- Father cannot feed or bond as well
C. Stages of Breastmilk
1. Colostrum available 2 4 days after delivery
Contents:
-
Low fats
Low carbohydrates
High protein
High immunoglobulin
High minerals
High fat-soluble vitamins
D. Cows milk
Contents:
- High fats
- Low carbohydrates (add sugar)
E. Health Teachings
1. Proper Hygiene
- Importance of hand washing
- Removal of caked colostrum
2. Position
- Upright sitting avoid tension to properly empty breast milk
3. Stimulate and evaluate feeding reflexes
a. Rooting
- touch side of lips or cheek and baby will turn to the stimulus
- purpose: to look for food
- disappear at 6 weeks because baby can already focus
b. Sucking
- by touching the middle of lips then baby will suck
- purpose: take in food
- disappear at 6 months
- easily disappear when not stimulated
c. Swallowing
- food touches posterior portion of tongue automatically swallowed
- never disappear cough, gag, sneeze
d. Extrusion/Protrusion reflex
- food touches anterior portion of tongue and tongue automatically extruded/protruded
- purpose: prevent from poisoning
- disappear by 4 months because baby can already spit out
4. The criteria of effective sucking
a. babys mouth is hike well up to areola
b. mother experiences after pain
c. other nipple is flowing with milk
5. To prevent from crack nipples and initiate proper production of oxytocin
- begin 2 3 minutes per breast
- increase 1 minute per day each breast until you reach 10 minutes each breast or 20 minutes per
feeding
6. For proper emptying and continuous milk production per feeding
- feed baby on the last breast that you fed him
CONTRAINDICATIONS IN BREASTFEEDING
Maternal Conditions
- HIV, Hepatitis B, CMV, comadin/warfarin sulfate intake
Newborn Conditions
- erythroblastosis fetalis
- hydrops fetalis
- phenylketonuria (PKU)
- galactosemia
- tay-sachs disease
5. Establishment of waste-elimination
A. Different stools
1. Meconium
- Physiologic stool
- Blackish green
- Sticky
- Tar like
- Odorless (because of sterile intestines)
- No bacteria
- Passed with in 24 36 hours
- Failure to pass meconium suspect GIT obstruction
a. hirschsprung
b. imperforate anus
c. meconium ileu (cystic fibrosis)
2. Transitional
- Become green, loose and slimy that may appear to be a slight diarrhea to the untrained eye
3. Breastfed stool
- Golden yellow, soft, mushy with sour milk smelling odor frequently passed occurring almost nearly
every feeding
4. Bottle-fed stool
- Light yellow, formed, hard with a typical offensive odor seldom passed 2 3 times a day
0
Absent
Absent
Score
1
Less than 100
Slow irregular weak
2
More than 100
Good strong cry
Flaccid extremities
cry
Some flexion
Well flexed
No response
No response
Blue/Pale
Grimace
Grimace
Acrocyanosis
(body and
extremities blue)
Cough or sneeze
Cry
Pink
CARDIO PULMONARY-RESUSCITATION
Airway (Clear Airway)
1. Shake, no response call for help
2. Place flat on bed
3. Head tilt chin lift maneuver
- Contraindicated to spinal cord injury
- Over extension may occlude airway
Breathing (Ventilating the lungs)
4. Check for breathlessness
5. Administer 2 rescue breaths
Circulation (by cardiac compression)
6. Check for pulselessness
7. Do CPR (when breathless and pulse less)
B. RESPIRATION EVALUATION
SILVERMAN ANDERSON INDEX CHART
Criteria
Chest movement
Intercostal
0
Synchronized
No retractions
Score
1
Lag on respiration
Just visible
2
See saw
Marked
retraction
Xiphoid retraction
Nares dilation
Expiratory grunt
None
None
None
Just visible
Minimal
Stethoscope
Marked
Marked
Naked ear
Interpretation of Result
0 3: Normal no respiratory distress syndrome
4 6: Moderate RDS
7 10: Severe RDS
28 32 weeks
Frog leg or lax position
Hypotonic muscle tone
Scarf sign (elbow passes the midline)
Square window wrist (90o angle)
Heel to ear sign
Abundant lanugo
Prominent labia minora and clitoris
5. Credes Prophylaxis
- Purpose: prevent opthalmia neonatorum (use erythromycine ophthalmic ointment)
6. Administration of Vitamin K
- Action: prevent hemorrhage
- Related to physiologic hypoprothrombinemia
- Give Aquamephyton, phytomenadione, konakoib (.5 1.5 mg, IM)
7. Weight-taking
Normal Weight: 3000 3400 grams/3 3.4 kg/6.5 7.5 lbs
Arbitrary Lower Limit: 2500 grams
Low Birth Weight: below 2500 grams
Small for Gestational Age: less 10 percentile rank
Large for Gestational Age: more than 90 percentile rank
Appropriate for Gestational Age: within the 2 standard deviation of the mean
Physiological Weight Loss: 5 10 percent occurs a few days after birth
E. PHYSICAL EXAMINATION AND DEVIATIONS FROM THE NORMAL
A. Important Considerations
a. If the client is new born, cover areas that is not being examined
b. If the client is infant, the first vital sign to take is RR (due to fear of stranger)
- Begin at east intrusive to the most intrusive
c. If the client is toddler and preschool, let them handle an instrument play syringe, stethoscope,
d. If the client is school age and adolescent explain procedure
COMPONENTS:
1. Vital signs
- Temperature is taken rectally to rule out imperforate anus and thermometer is inserted 1 inch
- Dont force insertion because it may lead to pruritus
- Types of imperforate anus
a. Atretic no anal opening, causing failure to pass meconium
b. Agenetic
- no anal opening, causing failure to pass meconium
- abdominal distention
- foul smelling stool
- vomitus of fecal materials
- respiratory problems
- Management: surgery with temporary colostomy
c. Membranous
RESPIRATION
- Abnormal/diaphragmatic
- Short period of apnea without cyanosis
- Normal apnea of newborn is less than 15 seconds
Respiration Check
Newborn
1 year
40-90
20-40
2-3 years
5 years
20-30
20-25
10 years
17-22
15 and above
12-20
Characteristics
Soft, low pitched, heard over periphery of lungs, inspiration
longer than expiration, normal.
BRONCHOVESICULA
R
BRONCHIAL
RHONCHI
RALES
WHEEZING
STRIDOR
RESONANCE
HYPERRESONANCE
LARYNGOTRACHEOBRONCHITIS
- Infection of larynx, trachea and bronchi
Assessment
- Barking cough/croupy cough
- Respiratory acidosis
Laboratory Studies
a. ABG
b. Throat culture
c. CBC
Diagnostic Studies
a. Chest and neck x-ray (to rule out epiglotitis)
Management
a. Bronchodilators
b. Oxygen with increase humidity
c. Prepare tracheostomy set when necessary
Broncholitis
- Inflammation of bronchioles characterized by production of thick tenacious mucous
Signs and Symptoms
- Cold like/flu like symptoms
- Causative agent: respiratory syncitial virus
- Drug: Ribavirin (anti viral drug)
- End stage epiglotitis (emergency condition or URTI), sudden onset
Management
- Tripod position (leaning forward with tongue protrusion)
- Never use tongue depressor
- Prepare tracheostomy set
- Encircle age
- Mist tent croup tent, croupette
- Nursing management
a. Check edges if properly tucked
b. Washable plastic material
c. Avoid toys that cause friction and hairy and furry materials
BLOOD PRESSURE
- 80/46 mmHg after 10 days 100/50
- Normal blood pressure taking begins by 3 years old
Alerts
- BP cuff must cover 50 75% (2/3) of upper arm
- To large cuff results to false low BP
- To small cuff results to false high BP
SKIN
ATOPIC DERMATITIS
- Infantile eczema
- Skin disease characterized by maculo vesicular errythematous lesion with weeping and
crusting
- Cause: allergens (main), milk, eggs, citrus juices, tomatoes and wheat
- Characterized by extreme pruritus
- Sign: linear excoriation, lichenified scaling
Management
- Treat main cause
- Prosorbbee or Isomil (milk)
- Hydrate skin with burrows solution
- Prevent infection
- Cut short the nails
IMPETIGO
- Cause: group A beta hemolytic streptococcus
- Characterized by populo vesicular surrounded by localized errythema becoming purulent
and ooze forming a honey colored crust
- Pediculosis capitis (kuto)
- Give oral penicillin
- AGN complication
ACNE
- Self limiting inflammatory disease affects sebaceous glands common in adolescence
- Signs: Comedones (sebum causing white heads)
- Sebum is composed of lipids
Management
- Proper hygiene
- Wash face with soap and water
- Use sulfur soap or mild soap
- Retin A
HEMOLYTIC DISORDER
a. Rh Incompatibility
- Mother negative, fetus positive
- 4th baby affected
- Mother negative, no antigen (no protein factor)
- Erythroblastosis fetalis: hemolysis leading to decrease oxygen carrying capacity with
pathologic jaundice within 24 hours
- Test: Combs Test
- Vaccine: Rhogam
- Given to RH negative mother within first 72 hours to destroy fetal RBC therefore preventing
antibody formation
b. ABO Incompatibility
- Mother is type O, fetus is type A, B, AB
- Most common is O, and A
- Severe O and B
- First pregnancy can be affected
Assessment
- Common is Hydrops fetalis, edematous on lethal state with pathologic jaundice within 24
hours
Management
1. Initiation of feeding, temporary suspension of breast feeding to prevent kernikterus
2. Pregnandiole delays action of glucoronyl transferace (liver enzyme that converts
indirect bilirubin to direct bilirubin)
3. Use of Phototherapy
4. Exchange Transfusion of Rh or ABO affectations that tend to cause continuous decrease in
hemoglobin during the first 6 months because bone marrow fails to produce erythrocytes in
response to continuing hemolysis.
Yellow Jaundice
Hyperbilirubinemia
- Normal: indirect bilirubin 0 3 mg/dl
- More than 12 mg/dl of indirect bilirubin in fullterm
Kernicterus
- Bilirubin encephalopathy more than 20 mg/dl indirect bilirubin in fullterm
- Less than 12 mg/dl in preterm because of immature liver
Physiological Jaundice
- Icterus neonatorum
- 48 72 hours
- Expose to sunlight
Pathological Jaundice
- Icterus gravis neonatorum
- Clinical jaundice within 24 hours
Breastfeeding Jaundice
- Pregnandiole
- 6 to 7 days
Assessment
- Blanching the neonates forehead , nose or sternum
- Yellow skin and sclera
- Light stool
- Dark urine
Management
Phototherapy
- Photo oxidation
- Height of 18 20 inches away from baby
Nursing Responsibilities
1. Cover the eyes prevent retinal damage
2. Cover genitals prevent priapism (painful continuous erection)
3. Change position for even exposure to light
4. Increase fluid intake to prevent dehydration
5. Monitor I & O weigh baby 1 gram:1 cc
6. Monitor Vital Signs
- Avoid use of lotion or oil because it may result to bronze baby syndrome
HEAD
Structures
Sutures: 3
- Management: proper hygiene, apply oil the night before shampooing (use baby oil or
coconut oil)
5. Hydrocephalus
- Collection of CSF
2 types
a. Communicating extra ventricular hydrocephalus
b. Non communicating intra ventricular hydrocephalus also called obstructive
Signs and Symptoms
- Sign of increase ICP
- Sign of frontal bossing (prominent forehead)
- Prominent scalp vein
- Sunset eyes
Therapeutic Management
- Place client in low semi fowlers position (30o)
- Osmotic diuretic
- Diamox (Acetazolamide) to decrease CSF production
- Seizure precaution
- Surgery (AV shunt, VP shunt)
- Shave just before surgery
- Place in side lying position on non operated side
- Monitor for good drainage
- Sunken fontanel is a good sign
- Mental retardation depend on extent of hydrocephalus
SENSES
CLEFT LIP
- Failure of the median maxillary nasal processes to fuse by 5 8 weeks of pregnancy
- Common in boys
- Can be unilateral or bilateral
CLEFT PALATE
- Failure of the palate to fuse by 9 12 weeks of pregnancy
- Common in girls
Signs and Symptoms
a. Evident at birth
b. Ultrasound/3 dimensional UTZ
c. Milk escape to the nostril
d. Common URTI (otitis, cholic)
Therapeutic Management
- Surgery
- Cleft lip: cheiloplasty done as early as 1 3 months to save sucking reflex
- Cleft palate: uranoplasty done 4 6 months to save speech
Nursing Responsibility
(Pre Op)
- Emotional support
- Proper nutrition
- Use Rubber tipped medicine dropper
- Prevention of cholic
a. Feed upright position
b. Burp twice
c. Prone position/on abdomen
- Orient parents to feeding technique
Cleft Lip
- Use rubber tipped syringe
Cleft Palate
- Use paper cup, plastic cup, soup spoon
- Use elbow restraints (pre op)
- So baby can easily adjust post op
(Post Op)
- Maintenance of airway
GASTROINTESTINAL SYSTEM
INBORN ERRORS OF METABOLISM
- Deficient liver enzyme
PHENYLKETONURIA
- Deficiency of liver PHT (Phenylalanine Hydroylase Transferase)
- No tyrosine, melanin, tyroxine basal metabolism
Signs and Symptoms
- Fair skin
- Blonde hair
- Blue eyes
- Accumulation of phenyl pyrobic acid in the blood
- Musty or mousy odor urine
- Atopic dermatitis
- Seizure
- Mental retardation
Diagnostic Tests
a. Guthrie test
Management
- Low phenylalanine indefinitely
- No food rich in protein (chicken, eggs, meat, legumes, peanut)
- Lofenalac = milk form for PKU
NEUROMUSCULAR SYSTEM
Reflexes
a. Blink reflex rapid eyelid closure when strong light is shown
b. Palmar grasp reflex solid object is placed on palm and baby grasp object
- Purpose: cling to mother for safety (disappear by 6 weeks 2 months)
c. Step in/Walk-in Place Reflex neonate placed on a vertical position with their
face touching a hard surface will take few quick, alternating steps.
- Placing Reflex: almost the same with step in place reflex only that you are
touching anterior surface of a newborns leg.
d. Plantar grasp reflex when an object touches the sole of a newborns foot at
the base of toes, the toes grasp in the same manner as fingers do (disappear by 8
9 months in preparation for walking)
e. Tonic-neck-reflex when newborns lie on their backs, their heads usually turn to
one side or the other. The arm and the leg on the side to which the head turns
extend, and the opposite arm and leg contract.
f. Moro reflex test for neurological integrity (jarring crib, loud voice) assume a
letter C position (disappear by 4 5 months)
g. Magnet reflex when there is pressure at the sole of the foot he pushes back
against the pressure.
h. Crossed extension reflex when the sole of foot is stimulated by a sharp object,
it causes the foot to rise and the other foot extend (test for spinal cord integrity)
i. Truck Incurvation reflex while in prone position and the paravertical area is
stimulated, it causes flexion of the trunk and swing his pelvis toward the touch.
j. Landau reflex while prone position and the trunk is being supported, the baby
exhibit some muscle tone (test for muscle tone and present by 6 9 months)
k. Parachute reaction while on ventral suspension with the sudden change of
equilibrium, it causes extension of the hands and legs (present by 6 9 months)
l. Babinski reflex when the sole of foot is stimulated by an inverted J, it causes
fanning of toes (disappear by 2 months but may persist up to 2 years)