The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which instruction should be included in the teaching?

Choice A reason:

Infants do not outgrow clubfoot when they learn to walk. Clubfoot is a congenital deformity that requires medical intervention to correct. Without treatment, the condition can lead to significant disability and difficulty in walking1. The goal of treatment is to correct the foot’s position and function, allowing the child to walk normally.

Choice B reason:

Surgical intervention is not the first line of treatment for clubfoot. While surgery may be necessary in severe cases or if other treatments fail, the initial approach typically involves non-surgical methods. The Ponseti method, which includes serial casting and gentle manipulation, is the preferred initial treatment. Surgery is considered only if these methods do not achieve the desired results.

Choice C reason:

Traction with foot manipulation is not a standard treatment for clubfoot. The primary non-surgical treatment involves the Ponseti method, which includes serial casting and gentle manipulation of the foot3. This method has been shown to be highly effective in correcting clubfoot without the need for traction.

Choice D reason:

Frequent serial casting is the first line of treatment for clubfoot. The Ponseti method, which involves weekly casting and gentle manipulation of the foot, is the most widely used and effective treatment for clubfoot. This method gradually corrects the foot’s position over several weeks, followed by bracing to maintain the correction4. Serial casting is preferred because it is non-invasive and has a high success rate.

Choice A reason:

Marbles are not a safe play activity for a 3-year-old in a spica cast. Marbles are small and can pose a choking hazard. Additionally, playing with marbles requires fine motor skills and movement that may be restricted by the cast.

Choice B Reason:

Watching a movie is a safe activity but does not provide developmental benefits. While it can keep the child entertained, it does not engage the child in active play or promote cognitive and motor development.

Choice C Reason:

A game of checkers may be too advanced for a 3-year-old. It requires understanding of rules and strategic thinking, which may be beyond the developmental stage of a child this age. Additionally, it may not be engaging enough to hold the child’s attention.

Choice D Reason:

Playing with a toy telephone is an appropriate activity for a 3-year-old in a spica cast. It is safe and can be done while the child is in a stationary position. This activity encourages imaginative play and can help with language development and social skills.