The biceps reflex is elicited by placing your thumb on the biceps tendon and striking the thumb with the reflex hammer and observing the arm movement. Repeat and compare with the other arm. Using a reflex hammer, deep tendon reflexes are elicited in all 4 extremities. Note the extent or power of the reflex, both visually and by palpation of the tendon or muscle in question.

Option B: This elicits the triceps reflex. The triceps reflex is measured by striking the triceps tendon directly with the hammer while holding the patient’s arm with your other hand. Repeat and compare to the other arm. The triceps reflex is mediated by the C6 and C7 nerve roots, predominantly by C7.
Option C: This elicits the patellar reflex. The patellar reflex is a deep tendon reflex, mediated by the spinal nerves from the levels L2, L3, and L4 in the spinal cord, predominantly in the root L4. The patellar reflex test is performed to determine the integrity of the neurological function, which is accomplished by hitting the patellar tendon below the knee cap with a test hammer
Option D: This elicits the radial nerve. For the testing of the brachioradialis reflex, the examiner places the patient in a seated position. From there, the clinician uses his or her forearm to support the patient’s forearm in a slightly pronated position. The physician supports the patient’s forearm rather than asking the patient to maintain the position to achieve relaxation of the muscle. Once in position, the physician delivers a series of quick hits to the area of the styloid process of the radius at the point of brachioradialis insertion.

Brethine is used cautiously because it raises the blood glucose levels. Terbutaline can cause a temporary increase in the baby’s heart rate and blood sugar levels. These side effects usually aren’t serious and are easy to treat after delivery if they occur. There are concerns about long term use of this drug because the incidence of danger to the baby increases.

Option A: Magnesium sulfate is indicated to prevent seizures associated with pre-eclampsia, and for control of seizures with eclampsia. Magnesium levels must be monitored frequently by checking serum levels every 6 to 8 hours or clinically by following patellar reflexes or urinary output. If serum concentration levels are low, a proper dose of magnesium sulfate can be given parenterally to replete low serum concentrations with recommended follow up laboratory testing.
Option C: Stadol is indicated for labor pain in full-term (37 weeks gestation or more) women without fetal distress in early labor. This medication is used to treat moderate to severe pain, including pain from surgery, muscle pain, and migraine headaches. Butorphanol is an opioid pain reliever similar to morphine. It acts on certain centers in the brain to give pain relief.
Option D: Ancef is generally acceptable for pregnant women. Controlled studies in pregnant women show no evidence of fetal risk. Cefazolin is an antibiotic used to treat a wide variety of bacterial infections. It may also be used before and during certain surgeries to help prevent infection. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria.

When the L/S ratio reaches 2:1, the lungs are considered to be mature. The Lecithin-to-Sphingomyelin Ratio (L/S ratio) is one of several methods for clinicians to assess fetal lung maturation. This biochemical test was first introduced in the 1970s, where a sample of amniotic fluid was collected via amniocentesis to determine the risk of the neonate developing respiratory distress syndrome (RDS). The sample was then evaluated, utilizing thin-layer chromatography to assess the size of lecithin relative to sphingomyelin.

Option A: The L/S ratio does not indicate congenital anomalies. Based on new guidelines, these indications no longer warrant testing the L/S ratio or performing other fetal lung testing modalities. One possible exception relates to inaccurate dating of the gestational age. If there is poor dating of the pregnancy and the delivery is to be planned between 32 to 39 weeks gestation, the clinician may consider testing for fetal lung maturity.
Option B: The infant is not at risk for intrauterine growth retardation. The main focus of testing the L/S ratio is to determine fetal lung maturity in an effort to decrease the risk of delivering a neonate with respiratory distress syndrome (RDS). RDS predominantly occurs in preterm infants less than 39 weeks gestation with increased risk with lesser gestational age.
Option D: The infant will most likely be small for gestational age and will not be at risk for birth trauma. The normal L/S ratio is 2.0 to 2.5 and is significant for appropriate fetal lung development. An L/S ratio of less than 2.0 is significant for immature fetal lung development. For patients who have poorly controlled diabetes, there was a discussion for the L/S ratio to be 3.0 due to elevated maternal glucose impacting the maturity of the developing fetal lungs.

Jitteriness is a sign of seizure in the neonate. For infants presenting with clinical signs compatible with hypoglycemia, like apnoea, hypotonia, jitteriness, apathy, hypothermia, tremors and seizures, treatment must ensure that blood glucose levels remain above 0.45 g/L (2.5 mmol/L). An IV bolus dose of glucose (150-200 mg/kg) should be administered urgently, followed by a constant rate infusion.

Option A: It’s normal for a baby to cry for 2–3 hours a day for the first 6 weeks. During the first 3 months of life, they cry more than at any other time. New parents often are low on sleep and getting used to life with their little one.
Option B: Generally, newborns sleep a total of about 8 to 9 hours in the daytime and a total of about 8 hours at night. But because they have a small stomach, they must wake every few hours to eat. Most babies don’t start sleeping through the night (6 to 8 hours) until at least 3 months of age. But this can vary a lot. Some babies don’t sleep through the night until closer to 1 year.
Option D: It is also common for newborns to hiccup, sneeze, yawn, spit up, burp, and gurgle. Sometimes newborns cry for no reason at all. If this happens, try comforting the baby by rocking, singing, talking softly, or wrapping him or her in a blanket.