One carpal spasm question-please guess

Nurses General Nursing

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I have just one question left now.:yeah:The answer is not in the IV study guide they gave me to study.:down:

1. When taking the blood pressure the patient exhibits a carpal spasm. Which should be assessed next?

Is the answer A, B, D?

A. Assess the Babinsky reflex

B. Check for Chvostek's sign

D. Determine LOC

In your opinion, which one is the BEST answer? (All of these answers sound good to me).

Please take a quess. Thanks;)

CRNA1982

97 Posts

Specializes in Anesthesia.

The answer is B

thinkertdm

174 Posts

Technically, it's not a "Babinski reflex". It's a plantar reflex, and it's a Babinski sign when the toes curl up. It can be a sign of a central nervous system lesion, or can be a normal variant in a small portion of people.

cindyloowho

143 Posts

B. They might have low calcium and a positive Chvostek's sign could help solidify that concern, although trousseau sign is usually a better indicator of low calcium than Chvostek's, but I do digress. Or, they may just have a hypersensitive trousseau's sign :-)

B

Or they might have c spine issues.

Meriwhen, ASN, BSN, MSN, RN

4 Articles; 7,907 Posts

Specializes in Psych ICU, addictions.

I also vote B, with a glass of milk ;)

austin14

16 Posts

its b because of low calcium levels. just had a question like this in my med-surg class

CRNA1982

97 Posts

Specializes in Anesthesia.
B

Or they might have c spine issues.

Not sure I understand? Can you elaborate?

Blackcat99

2,836 Posts

Thanks to everyone.:heartbeat I really appreciate your help. This last question had been driving me crazy.

Now I know the answer is B.:yeah:

morte, LPN, LVN

7,015 Posts

Not sure I understand? Can you elaborate?

i'm thinkin, she's thinkin, an irritated nerve in the C-spine contributing to the carpal spasm??

CRNA1982

97 Posts

Specializes in Anesthesia.

I can't say I have ever seen a pt. with a carpal spasm secondary to C-spine nerve impingement. Usually they present with paresthesias (numbness/tingling in upper extremities)

Esme12, ASN, BSN, RN

1 Article; 20,908 Posts

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

symptoms

http://en.wikipedia.org/wiki/hypocalcaemia

http://www.umm.edu/ency/article/003194.htm

carpopedal spasm, which was reproducible by inflating a blood-pressure cuff placed on the patient's arm. chvostek's sign, the twitching of the circumoral muscles with tapping lightly over the facial nerve, was also present ....

http://www.nejm.org/doi/full/10.1056/nejmicm074227

babinskis reflex

reflexes are predictable, uncontrollable responses to a certain type of stimulation.

babinski's reflex is one of the reflexes that occurs in infants. it is normal in children up to 2 years old, but it disappears as the child gets older and the nervous system becomes more developed. it may disappear as early as 12 months.

the presence of a babinski's reflex after age 2 is a sign of damage to the nerve paths connecting the spinal cord and the brain (the corticospinal tract). this tract runs down both sides of the spinal cord. a babinski's reflex can occur on one side or on both sides of the body.

an abnormal babinski's reflex can be temporary or permanent.

the plantar reflex is a [color=#0645ad]reflex elicited when the sole of the foot is stimulated with a blunt instrument. the reflex can take one of two forms. in normal adults the plantar reflex causes a downward response of the [color=#0645ad]hallux ([color=#0645ad]flexion). an upward response ([color=#0645ad]extension) of the [color=#0645ad]hallux is known as babinski response, babinski sign, or koch sign, named after [color=#0645ad]joseph babinski (1857–1932), a [color=#0645ad]french[color=#0645ad][1] [color=#0645ad]neurologist of [color=#0645ad]polish origin. the presence of the babinski sign can identify [color=#0645ad]disease of the [color=#0645ad]spinal cord and [color=#0645ad]brain in adults, and also exists as a [color=#0645ad]primitive reflex in [color=#0645ad]infants.[color=#0645ad][2]

[color=#0645ad][http://en.wikipedia.org/wiki/plantar_reflex

http://www.youtube.com/watch?v=c_5_xfjxt4g&feature=related

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