A nurse is preparing to test a client’s plantar Babinski reflex. Which of the following instructions should the nurse give to prepare the client for this test?
A.
“Place your foot in my hand and I will tap the back of your heel.”
B.
“Lie down and I will stroke the bottom of your foot.”
C.
“Sit on the edge of the bed while I tap your knee.”
D.
“Relax your arm across your chest and I will test your elbow extension.”
The correct answer and Explanation is :
The correct answer is B. “Lie down and I will stroke the bottom of your foot.”
Explanation:
The plantar Babinski reflex test is performed to assess the neurological function and integrity of the pathways involved in the reflex arc, particularly the corticospinal tract. This reflex test is commonly used to evaluate the function of the central nervous system, especially in adults.
To correctly perform the test, the nurse should ensure the patient is in a comfortable position where the foot can be easily accessed. Here’s a breakdown of the procedure and the rationale behind the instruction:
- Positioning the Patient: The patient should ideally be lying down or in a relaxed position where the foot can be extended and examined without resistance. This ensures that the test is conducted under natural conditions where the reflex can be accurately assessed.
- Stimulating the Foot: The nurse uses a pointed object (such as the end of a reflex hammer) to stroke the lateral aspect of the sole of the foot, from heel to toes. This should be done firmly but gently to elicit the reflex response.
- Interpreting the Response: In a normal adult, the plantar reflex should be a downward flexion of the toes (a negative Babinski sign). However, an abnormal response, such as an upward extension of the big toe and fanning of the other toes (a positive Babinski sign), could indicate a neurological issue, such as damage to the corticospinal tract.
The other options are not appropriate for this test:
- A. “Place your foot in my hand and I will tap the back of your heel.”: This instruction pertains to a different test, such as the Achilles tendon reflex.
- C. “Sit on the edge of the bed while I tap your knee.”: This describes the procedure for the patellar reflex, not the plantar reflex.
- D. “Relax your arm across your chest and I will test your elbow extension.”: This instruction does not relate to the plantar Babinski reflex at all.
Thus, option B correctly describes the appropriate position and action for performing the plantar Babinski reflex test.