The nurse is performing a neurological assessment on a 6-year-old female who sustained a head injury after falling off a bike. Which technique is most appropriate for the nurse to use to assess the child’s pupillary light reflex?
Added by Ashley V.
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Step 1: Dim the room and explain the procedure to the child to reduce anxiety and obtain cooperation. Show more…
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Activity 4: Initiating Pupillary Reflexes 1. Conduct the reflex testing in an area where the lighting is relatively dim. Before beginning, obtain a flashlight and a metric ruler. 2. Measure and record the size of the subject's pupils as best you can. Note: It may be easier to measure the size of the pupil in an individual with light-colored eyes. Right pupil: mm Left pupil: mm 3. Stand to the left of the subject to conduct the testing. The subject should shield his or her right eye by holding a hand vertically between the eye and the right side of the nose. 4. Using a quick right-to-left motion, shine a flashlight into the subject's left eye. What is the pupillary response? Measure the size of the left pupil:
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Activity 6: Initiating Pupillary Reflexes Right pupil: mm Left pupil: mm Shine a flashlight into the subject's left eye. What is the pupillary response? Measure the size of the left pupil: mm (approximately, with ruler held close) Observe the right pupil. Has the same type of change (called a consensual response) occurred in the right eye? Measure the size of the right pupil: mm When a contralateral response occurs, what does this indicate about the pathways involved? Was the sympathetic or the parasympathetic division of the autonomic nervous system active during the testing of these reflexes? What is the function of these pupillary responses?
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