Observer should note its intensity,rate, rhythm, and if any blood vesseltenderness, tortuosity, or nodularityexists.

A satisfactory pulse can be takenradially in children older than 2 yrs old

In infants and younger childrenthe apical pulse is more reliable

Count the pulse for 1 full minute ininfants and young children b/c ofpossible irregularities in rhythm

When frequency apical pulses areneeded, use shorter counting time(15-30 sec intervals)

Compare radial and femoral pulses atleast once during infancy to detect thepresence of circulatory impairment,such as coarctation in the aorta.

A reflex is a motor response to a sensory

stimulation that is used in an assessment to

observe the integrity of the nervous system. They

elicit a muscle contraction when the muscle's

tendon is stimulated.

The patient should be relaxed. The muscle should

be placed on a slight stretch. A reflex hammer taps

the tendon with an anticipated immediate

response. Both sides of the body should be

assessed. Reflexes can be graded as normal,

exaggerated, or depressed, or no a scale of 0-4.

Biceps Tendon

Brachioradialis Tendon

Triceps Tendon

Patellar Tendon

Tibialis Posterior Tendon

Achilles Tendon

0 absent reflex

1+ trace, or seen only with

reinforcement

2+ normal

3+ brisk

4+ nonsustained clonus (i.e.,

repetitive vibratory movements

5+ sustained clonus