What it means
When a person holds the arms straight out and bends the hands back at the wrist, the hands keep dropping forward and jerking back, like a bird flapping its wings. It comes from brief losses of muscle tone, not from a true tremor. It is best known in hepatic encephalopathy, when a failing liver lets toxins such as ammonia reach the brain, and is also seen in kidney failure and with high carbon dioxide levels.
For the nurse
Ask the client to stretch out the arms and bend the hands back "like stopping traffic" and watch for 30 seconds. In a client with liver disease, report new asterixis or confusion, and give ordered drugs such as lactulose.
At a glance
| Also written | flapping tremor, liver flap |
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Related terms
tremor
Shaking of a part of the body, such as the hands, in small rhythmic movements that the person cannot control.