Question

Describe how the obstetrics would perform a physical assessment on the uterus of a mother immediately after delivery. The nurse is performing a newborn assessment and understands the importance of documenting reflexes. Describe how you would assess the following reflexes: tonic neck, moro, and Babinski reflexes.

Answer 1

Assessment of Uterus-

It should be firm, if not, massage prior palpation & assess for any blood discharged during massage.

Assess its location and the degree of uterus contraction, any tenderness or pain should be noted.

Normal findings: normal shape and size, mobile, regular, firm, in the midline, below the umbilicus & non tender.

Tonic neck reflex in newborn-The symmetrical tonic neck reflex can be tested by placing the child in quadruped position on the floor and passively flexing the head forward and then extend it backwards. The expected response would be forward head flexion producing flexion of the upper extremities and extension of the lower extremities while extension of the head will produce extension of the upper extremities and flexion of the lower extremities.

Moro reflex-

The Moro reflex is an infantile reflex that develops between 28–32 weeks of gestation and disappears between 3–6 months of age. It is a response to a sudden loss of support and involves three distinct components:

Spreading out the arms (abduction)

Pulling the arms in (adduction)

crying (usually)

Today, the most common method is the head drop, where the infant is supported in both hands and tilted suddenly so the head is a few centimeters lower than the level of the body.

Babiniski reflex-

Babinski reflex is one of the normal reflexes in infants.

The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out.

This reflex is normal in children up to 2 years old. It disappears as the child gets older. It may disappear as early as 12 months.