Page 707 - Saunders Comprehensive Review For NCLEX-RN

When released, foot drops to plantar-flexed position with no
oscillations.
Abnormal response (positive clonus response):
Rhythmic oscillations occur when foot is dorsiflexed.
Similar oscillations are noted when foot drops to plantar-flexed
position.

Grading Response

0 Reflex absent
1 + Reflex present but hypoactive
2 + Normal reflex
3 + Hyperactive reflex
4 + Hyperactive reflex with clonus present

Box 22-6

Eclampsia

1. Seizure typically begins with twitching around the mouth.
2. Body then becomes rigid in a state of tonic muscular contractions that last 15 to
20 seconds.
3. Facial muscles and then all body muscles alternately contract and relax in
rapid succession (clonic phase may last about 1 minute).
4. Respiration ceases during seizure because diaphragm tends to remain fixed
(breathing resumes shortly after the seizure).
5. Postictal sleep occurs.

FIG. 22-3 Three classifications of placenta previa.

707