The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations would the nurse expect to observe? (Select all that apply.)
Positive Ortolani click
Unequal gluteal folds
Trendelenburg sign
Negative Babinski sign
Telescoping of the affected limb
Correct Answer : A,B,C,E
The correct answer is a) Positive Ortolani click, b) Unequal gluteal folds, c) Trendelenburg sign, and e) Telescoping of the affected limb.
Choice A reason:
A positive Ortolani click is a clinical manifestation of developmental dysplasia of the hip (DDH). The Ortolani maneuver is used to detect hip dislocation or subluxation in infants. When the hip is abducted and gentle pressure is applied to the proximal thigh from behind, a palpable “clunk” is noticed as the femoral head relocates into the acetabulum. This indicates hip instability, which is a characteristic of DDH.
Choice B reason:
Unequal gluteal folds are another clinical manifestation of DDH. Asymmetrical gluteal creases can suggest hip dysplasia in infants. This is because the dislocation or subluxation of the hip can cause one leg to appear shorter than the other, leading to uneven gluteal folds.
Choice C reason:
The Trendelenburg sign is a clinical test used to assess the integrity and strength of the hip abductor muscles, particularly the gluteus medius and gluteus minimus. A positive Trendelenburg sign usually indicates weakness in these muscles, which can be associated with hip abnormalities such as congenital hip dislocation3. In DDH, the hip instability can lead to a positive Trendelenburg sign.
Choice D reason:
A negative Babinski sign is not a clinical manifestation of DDH. The Babinski reflex is a normal reflex in infants up to 2 years old, where the big toe moves upward and the other toes fan out when the sole of the foot is stroked. A negative Babinski sign would indicate the absence of this reflex, which is not related to DDH.
Choice E reason:
Telescoping of the affected limb is a clinical manifestation of DDH. In a child with DDH, the hip socket is shallow, and the head of the femur may slip in and out, leading to a telescoping effect. This means the femoral head can move further out of the socket, causing the limb to appear shorter or longer depending on the position.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Wearing cotton underpants is recommended to prevent urinary tract infections (UTIs) in young girls. Cotton is a breathable fabric that allows air to circulate, reducing moisture and creating an environment less conducive to bacterial growth. This helps to keep the genital area dry and clean, which is important in preventing UTIs.
Choice B reason:
Limiting trips to the bathroom is not recommended for preventing UTIs. In fact, it is important for young girls to urinate frequently to flush out bacteria from the urinary tract. Holding urine for extended periods can increase the risk of bacterial growth and infection. Therefore, encouraging regular bathroom trips is a better practice for preventing UTIs.
Choice C reason:
Decreasing salt intake is not directly related to preventing UTIs. While a healthy diet is important for overall health, there is no specific evidence linking salt intake to the prevention of urinary tract infections. The focus should be on practices that directly reduce the risk of bacterial growth and infection in the urinary tract.
Choice D reason:
Soaking in a bathtub, especially with bubble baths or perfumed soaps, can increase the risk of UTIs. These substances can irritate the urethra and create an environment conducive to bacterial growth. It is better to avoid prolonged baths with such products and instead opt for quick showers to maintain hygiene without increasing the risk of infection.
Correct Answer is A
Explanation
Choice A reason:
Oral rehydration solution (ORS) is the first-line treatment for children with acute diarrhea and moderate dehydration. ORS contains a precise balance of electrolytes and glucose, which helps to rehydrate the child effectively by promoting the absorption of water and electrolytes in the intestines. The World Health Organization (WHO) and the American Academy of Pediatrics recommend ORS as the preferred treatment for dehydration caused by diarrhea. It is effective, easy to administer, and can be given at home or in a healthcare setting.
Choice B reason:
Antidiarrheal medications such as paregoric are not recommended for children with acute diarrhea. These medications can slow down the movement of the intestines, which may prolong the infection and increase the risk of complications. Additionally, they do not address the underlying cause of dehydration. The primary goal in managing acute diarrhea is to rehydrate the child, which is best achieved with ORS.
Choice C reason:
Clear liquids, such as water, broth, or diluted fruit juices, can be used to provide some hydration, but they do not contain the necessary electrolytes to effectively treat moderate dehydration. Clear liquids alone are not sufficient to replace the lost electrolytes and fluids caused by diarrhea. ORS is specifically formulated to address these needs and is more effective in rehydrating the child.
Choice D reason:
Adsorbents, such as kaolin and pectin, are not recommended for the treatment of acute diarrhea in children. These substances can bind to the contents of the intestines and may reduce the frequency of stools, but they do not address the underlying dehydration. The primary focus should be on rehydration with ORS, which provides the necessary electrolytes and fluids to restore the child’s hydration status.
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