A 7-month-old infant is admitted to the unit with suspected bacterial meningitis after receiving an initial dose of antibiotics in the emergency department. Frequent assessment of which of the following is most important in the plan of care?
1. Babinski reflex
2. Fontanel assessment3. Pulse pressure
4. Pupillary light response

Babinski reflex is the correct assessment to use as care plan.

Explanation: By understanding the following care plans, we can know the assessment care plan for the baby. For instance:

1. Babinski reflex is one of the normal reflexes in infants. Reflexes are responses that occur when the body receives a certain stimulus.

The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out.

This reflex is normal in children up to 2 years old. It may disappear as early as 12 months or as the child gets older. It is usually caused when the Babinski reflex is present in a child older than 2 years or in an adult, it is often a sign of a central nervous system disorder. The central nervous system includes the brain and spinal cord. Disorder may include meningitis (infection of the membranes covering the brain and spinal cord).

2. Fontanelle assessment is used to assess fontanelles in babies. Unlike adults, babies have skull bones that are not firmly joined together. The spaces between the skull bones are important as they allow the bones to move, and even overlap, when the baby passes through the birth canal. These spaces also allow room for the baby’s brain to grow.

You may notice one such space, or fontanelle, at the front on top of the head and another smaller fontanelle at the back of the head. Over time, the fontanelles harden and close. The fontanelle at the back of your baby’s head usually closes by the time your baby is 2 months old. The fontanelle at the top usually closes sometime between the ages of 7 months and 18 months.

3. Pulse pressure is the difference between systolic and diastolic blood pressure. It is measured in millimeters of mercury (mmHg). It represents the force that the heart generates each time it contracts. The normal resting blood pressure is approximately 120/80 mmHg, which yields a pulse pressure of approximately 40 mmHg.

4.Pupillary light response (PLR) is the reduction of pupil size in response to direct light. This is the most common stimulus for pupillary constriction. Reflex pupillary constriction is also involved in convergence and accommodation for nearby objects. Pupillary light response is often used to determine which cranial nerves are damaged in an injury.

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