When assessing the health of a preterm baby born through a difficult delivery, the nurse notices that the baby is unable to elevate the right arm, which lies limply at his side. The grasp reflex is found to be present in the infant
Which of the following does the nurse suspect in the child, possibly as a result of trauma during birth? A) Fractured clavicle
B) Intracranial hemorrhage
C) Brachial plexus injury
D) Bell's palsy
C
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Injury to the brachial plexus can result from trauma during a difficult delivery. Erb-Duchenne paralysis is a common type of brachial plexus injury, which results from trauma to the fifth and sixth cranial nerves. The baby is unable to elevate the affected arm, which lies limply at the side, but the grasp reflex is present. Signs of a fractured clavicle include asymmetrical Moro's reflex and crying when the affected arm is moved. The signs and symptoms of intracranial hemorrhage include seizures, respiratory distress, cyanosis, a shrill cry, and muscle weakness. In Bell's palsy or facial paralysis, usually only one side of the face is affected, and the eyelid and mouth may droop on that side.
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