While assessing a 4-day-old neonate delivered at 28 weeks’ gestation, the nurse cannot elicit the neonate’s Moro reflex, which was present 1 hour after birth. The nurse notifies the physician because this may indicate which of the following?
1. Postnatal asphyxia.
2. Skull fracture.
3. Intracranial hemorrhage.
4. Facial nerve paralysis.
When the nurse cannot elicit the Moro reflex of a 4-day-old preterm infant and the Moro reflex was present at birth, intracranial hemorrhage or cerebral edema should be suspected. Other symptoms include lethargy, bulging fontanels, and seizure activity. Confirmation can be made by ultrasound. Postnatal asphyxia is suggested by respiratory distress, grunting, nasal flaring, and cyanosis. A skull fracture can be confirmed by radiography. However, it is unlikely to occur in a preterm neonate. Rather, it is more common in the large- for-gestational-age neonate. Facial nerve paralysis is indicated when there is no movement on one side of the face. This condition is more common in the large- for-gestational-age neonate.
CN: Reduction of risk potential; CL: Analyze