A 10-month-old infant diagnosed with developmental dysplasia of the hip (DDH) has been fitted with a Pavlik harness. During a follow-up visit, the nurse notices redness and skin breakdown under the straps. What is the most appropriate nursing action to address this complication while maintaining effective treatment?

A. Coarctation of the Aorta is incorrect because this defect causes obstruction of blood flow from the left ventricle to the aorta. It is a pressure load problem (left ventricular hypertension) rather than a left-to-right shunt, and it does not primarily increase pulmonary blood flow.

B. Tetralogy of Fallot is incorrect because this is a cyanotic defect characterized by right-to-left shunting due to pulmonary stenosis and a VSD. Pulmonary blood flow is often decreased rather than increased.

C. Transposition of the Great Arteries is incorrect because this is a cyanotic defect in which the aorta arises from the right ventricle and the pulmonary artery from the left ventricle, resulting in parallel circulation. Pulmonary blood flow is not increased by a left-to-right shunt.

D. Ventricular Septal Defect (VSD) is correct because it is a acyanotic defect that allows blood to flow from the left ventricle (higher pressure) to the right ventricle (lower pressure). This left-to-right shunt increases pulmonary blood flow, which can lead to symptoms such as tachypnea, poor weight gain, and frequent respiratory infections. VSDs are the most common congenital heart defect in infants.

A. Quickening experienced by the patient is incorrect because quickening (the first perception of fetal movement by the mother) is considered a presumptive sign of pregnancy, not a positive sign. While it suggests pregnancy, it can be mistaken for gastrointestinal activity.

B. Patient reports of a positive pregnancy test is incorrect because this is a probable sign of pregnancy. Laboratory tests detecting human chorionic gonadotropin (hCG) are more reliable than presumptive signs, but they can occasionally give false positives (e.g., due to certain medications or medical conditions).

C. Braxton Hicks contractions felt by the patient is incorrect because these are also presumptive or possible signs of pregnancy. They indicate uterine activity, but they do not confirm the presence of a fetus.

D. Fetal movement palpated by the provider is correct. This is considered a positive sign of pregnancy, as only a developing fetus can cause these movements to be felt by an examiner. Other positive signs include visualization of the fetus on ultrasound and auscultation of the fetal heartbeat. Positive signs provide definitive confirmation of pregnancy, distinguishing them from presumptive or probable signs.