Topics

• History
• Screening and Health Promotion
• Pediatric Variations

NDNP 819: Advanced Health Assessment Across the Lifespan

Module: Neurological

Pediatric Variations

Infants

The neurological system is not completely developed at birth and motor activity of the newborn is under control of the spinal cord and medulla. Movements are directed primarily by primitive reflexes and were presented in a previous module. Persistence of the primitive reflexes is an indication of CNS dysfunction. Neurological development proceeds in a head to toe fashion and milestones occur in an o orderly sequence although the exact age of the occurrence may vary.

The Aging Adult

The aging process causes generalized atrophy and a steady loss of neurons in the brain and spinal cord. By 80 years of age, the brain has decreased in weight by 15% due to losses in weight and volume. Impaired fine coordination and agility, loss of vibratory sense at the ankle, decreased or absent Achilles reflex, loss of position sense at the big toe and decreased pupillary reflexes can be expected finding in the older adult. Reaction time is slower and touch/pain sensation, taste and smell may be diminished. Aging has a progressive decrease in cerebral blood flow and may cause individuals to get dizzy or loose balance with position change. Teach older clients to get up slowly and educate them for their increased risk of falls.