Xavier University - Ateneo De Cagayan

College of Nursing

In Partial Fulfillment in:

CA 1
Case Study on Care of the Newborn

Submitted by:
ESCALA, Stephanie Joy
BSN 4 Block NB

Submitted to:
Mr. Philip Eli Nalzaro, RN, MN
Mrs. Leny Baguio, RN, MN
Mrs. Renzi Pepito, RN, MN
Mrs. Mildred Pinque, RN, MN
Mrs. Mary Grace Paayas, RN, MAN

September 2017
Case Study:
Mrs. Calland delivered (vaginally) a baby boy today. Baby boy Calland was to be
evaluated 38 weeks gestation and weigh 3,200 g. Mrs. Calland plans to breastfed her
baby. You are assigned as the nurse to take care of her and her baby.
1. Shortly after deliver, several reflexes were tested on the infant. Make a list of
reflexes that were tested and explain which maneuvers were used and
complete the tests.
2. Within 12 hours after birth, the infant passed a sticky black stool. Explain why
this should not alarm you.
3. On the day of discharge, baby boy Calland appears to have yellow skin and
sclera. What lab test might be ordered at this time? What would be indicated if
the results are higher than normal results?

Answers:
1. List of reflexes:
a. Blink Reflex
- It may be elicited by shining a strong light such as a flashlight or an
otoscope light on an eye. A sudden movement toward the eye
sometimes can elicit the blink reflex.
b. Rooting Reflex
- If the cheek is brushed or stroked near the corner of the mouth, a
newborn infant will turn the head in that direction. This reflex serves to
help a newborn find food.
c. Sucking Reflex
- When a newborns lips are touched, the baby makes a sucking motion.
The reflex helps a newborn find food.
d. Extrusion Reflex
- A newborn extrudes any substance that is placed on the anterior
portion of the tongue. This protective reflex prevents the swallowing of
inedible substances.
e. Palmar Grasp Reflex
- . Newborns grasp an object placed in their palm by closing their fingers
on it. Mature newborns grasp so strongly that they can be raised from a
supine position and suspended momentarily from an examiners fingers.
f. Plantar Grasp Reflex
- When an object touches the sole of a newborns foot at the base of the
toes, the toes grasp in the same manner as do the fingers
g. 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 toward which the head
turns extend, and the opposite arm and leg contract.
h. Moro Reflex
- A Moro (startle) reflex (Fig. 18.7) can be initiated by startling a newborn
with a loud noise or by jarring the bassinet. The most accurate method
of eliciting the reflex is to hold newborns in a supine position and allow
 their heads to drop backward about 1 inch. In response to this sudden
head movement, they abduct and extend their arms and legs.
i. Babinski Reflex
- When the sole of the foot is stroked in an inverted J curve from the
heel upward, a newborn fans the toes (positive Babinski sign). This is in
contrast to the adult, who flexes the toes. This reaction occurs because
nervous system development is immature.
j. Magnet Reflex
- If pressure is applied to the soles of the feet of a newborn lying in a
supine position, he or she pushes back against the pressure. This and
the two following reflexes are tests of spinal cord integrity.
k. Landau Reflex
- A newborn who is held in a prone position with a hand underneath,
supporting the trunk, should demonstrate some muscle tone. Babies
may not be able to lift their head or arch their back in this position (as
they will at 3 months of age), but neither should they sag into an inverted
U position. The latter response indicates extremely poor muscle tone,
the cause of which should be investigated.

2. Baby Calland excreted meconium. Usually, within 24 hours after birth, the first
stool of a newborn is sticky, tarlike, blackish-green and odorless. Meconium if
formed from mucus, vernix, lanugo, hormones and carbohydrates that
accumulate during intrauterine life. If Baby Calland did not pass a meconium
stool by 24 to 48 hours after his birth, conditions such as paralytic ileus and
imperforate anus may be suspected.

3. Baby Calland was experiencing