The practical nurse (PN) is reviewing education for the parents of an infant with developmental dysplasia of the hip about dynamic splinting.
Which information should the PN reinforce about the purpose of this treatment?
Promotes range-of-motion.
Increases extension.
Maintains abduction.
Provides immobilization.
The Correct Answer is C
Choice A rationale
Promoting range-of-motion is typically achieved through exercises and movement. Dynamic splinting aims to maintain a specific joint position rather than actively increasing range of motion, which might be counterproductive to hip stability in developmental dysplasia.
Choice B rationale
Increasing extension would involve straightening the hip joint. In developmental dysplasia of the hip, the goal of treatment is to maintain the femoral head within the acetabulum, which often requires a flexed and abducted position, not extension.
Choice C rationale
Maintaining abduction is the primary purpose of dynamic splinting in developmental dysplasia of the hip. Abduction helps to seat the femoral head deeply into the acetabulum, promoting proper hip development and stability by stimulating acetabular ossification.
Choice D rationale
Providing immobilization implies completely restricting movement. Dynamic splinting, like the Pavlik harness, allows some movement while maintaining the abduction, flexion, and external rotation necessary for proper hip development. Full immobilization is typically not the goal for developmental dysplasia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Monitoring serum electrolytes is the top priority for an infant with congenital adrenal hyperplasia (CAH). This condition involves an enzymatic defect that impairs cortisol and aldosterone synthesis, leading to salt wasting due to insufficient aldosterone. This can cause life-threatening hyponatremia and hyperkalemia, requiring urgent intervention. Normal ranges are typically sodium 135-145 mEq/L and potassium 3.5-5.0 mEq/L.
Choice B rationale
Checking for hypothermia is important for any neonate or infant, as they have immature thermoregulation. While a general nursing intervention, it is not the most specific or life-threatening concern directly related to the pathophysiology of congenital adrenal hyperplasia, which primarily involves electrolyte imbalances.
Choice C rationale
Assessing for urinary tract infection is a relevant general health assessment, especially in infants with ambiguous genitalia, due to potential anatomical variations. However, while important for overall health, it does not address the immediate, life-threatening metabolic derangements associated with congenital adrenal hyperplasia.
Choice D rationale
Recording daily weights is crucial for assessing fluid balance in infants, particularly those at risk for dehydration or fluid retention. While important for monitoring overall health and fluid status, it is secondary to the critical need to monitor and correct acute electrolyte imbalances that can rapidly become life-threatening in CAH.
Correct Answer is A
Explanation
Choice A rationale
Methylergonovine is an ergot alkaloid that directly stimulates sustained uterine contractions. This action is crucial in controlling postpartum hemorrhage by compressing blood vessels within the myometrium, thereby reducing blood loss. The observed excessive bleeding with this delivery necessitates intervention to prevent complications like hypovolemic shock. Its pharmacological effect targets smooth muscle receptors in the uterus.
Choice B rationale
Routine prescription based solely on parity (number of previous pregnancies) is not standard medical practice. Methylergonovine is administered based on clinical indication, primarily to prevent or manage postpartum hemorrhage, which is determined by factors like uterine atony or excessive bleeding, not simply the number of previous births. Unnecessary administration can lead to adverse effects.
Choice C rationale
While methylergonovine does contract the uterus and prevent excess bleeding, this response is a general statement. The best response directly addresses the client's current situation and her question about why *she* is receiving it *this time*. It is crucial to explain the specific clinical reason for her individual prescription, which in this context is likely due to the increased bleeding.
Choice D rationale
This response shifts the responsibility back to the client and does not provide the requested information. It fails to address the client's direct question about the medication's purpose in her specific situation. Providing clear and concise information is essential for client education and adherence to the treatment plan.
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