The nurse suspects a newborn has a fractured clavicle. What are ...

[Ebrown]

The nurse suspects a newborn has a fractured clavicle. What are signs of a fractured clavicle? (Select all that apply.)
 
  a. An asymmetric Moro reflex
  b. Limited use of the affected arm
  c. Crying when the arm is moved
  d. Muscles of the hand are paralyzed
  e. The arm hangs limp alongside the body

Question 2

The clinic nurse is assessing infant reflexes. What assessment indicates a persistence of primitive reflexes?
 
  a. Tonic neck reflex at 8 months of age
  b. Palmar grasp at 4 months of age
  c. Plantar grasp at 9 months of age
  d. Rooting reflex at 3 months of age

[ergserg]

Answer to Question 1

ANS: A, B, C
A newborn with a fractured clavicle may have no signs, but the nurse should suspect a fracture if an infant has limited use of the affected arm, malpositioning of the arm, an asymmetric Moro reflex, or focal swelling or tenderness or cries when the arm is moved. Paralyzed hand muscles and an arm that hangs limp alongside the body are signs of Erb palsy.

Answer to Question 2

ANS: A
Persistence of primitive reflexes is one of the earliest clues to CP (e.g., obligatory tonic neck reflex at any age or nonobligatory persistence beyond 6 months of age and the persistence or even hyperactivity of the Moro, plantar, and palmar grasp reflexes). The palmar grasp disappears by 6 months, the plantar grasp disappears by 12 months, and the rooting reflex disappears at 4 months, so these are normal findings.