Plantar reflex present. The nurse should make a light, upside-down "J"-shaped stroke with the same tool across the ball of the foot and up the lateral side of the sole.
The typical reaction is plantar flexion of the toes, and occasionally the entire foot. When the big toe responds by dorsiflexing and all other toes fan out, the Babinski sign is positive, which is abnormal. A 0 to 4+ scale is not used to grade the plantar reflex. In patients who are unconscious or who may have suffered injuries to the lumbar 5-5 or sacral 1-2 regions of the spinal cord, the plantar reflex is the only superficial reaction that should be evaluated. With the handle of a reflex hammer or a tongue blade, stimulate the bottom of the foot.
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