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Nurs 306 Final Exam Question and answers rated A+ Developmental Dysplasia of the Hip - correct answer Conditions in which the femoral head has an abnormal relationship so the acetabulum (hip socket) Incidence and etiology -incidence of hip instability of some kind is approx 1-2 in 1,000 ...

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  • November 19, 2024
  • 47
  • 2024/2025
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Nurs 306 Final Exam Question and
answers rated A+
Developmental Dysplasia of the Hip - correct answer ✔Conditions in which
the femoral head has an abnormal relationship so the acetabulum (hip socket)


Incidence and etiology
-incidence of hip instability of some kind is approx 1-2 in 1,000 live births
-affects females more than males
-multi-factorial etiology, but environmental and genetic factors clearly play a
role
-identical twins
--36% increased chance of both twins having DDH


Patho
-prenatal factors that influence development of DDH include maternal
hormone secretion (relaxin)
-other prenatal factors include
--frank breech presentation
--twinning
--large infant size
-post-natal positioning such as swaddling/tightly wrapping infant in blankets
has been associated with DDH
-genetic factors
-3 degrees of DDH
--acetabular dysplasia
---mildest form

,---delay in acetabular development but femoral head remains in acetabulum
--subluxation
---femoral head remains in contact with the acetabulum, but a stretched
capsule and ligament causes the head of the femur to be partially displaced
---most common type
--dislocation
---complete loss of contract of femoral head with acetabulum


Clinical Manifestations
-unequal leg length
-asymmetry of thigh and gluteal folds
-limited abduction on affected side
-older child
--gait abnormalities
--level of pelvis may be unequal
--shortening of one limb


Diagnosis
-ideally made in the newborn period
-Barlow maneuver
--examiner pushes an unstable femoral head out of the acetabulum by use of
gentle lateral pressure of the lower trochanter
--out
-Ortolani maneuver
--examiner reduces dislocated femoral head into the acetabulum by gentle
abduction and external rotation
--a "clunk" is heard and felt as this occurs

,--back in
-radiographic exam is used for infants/children over 4 months of age (bones
are largely cartilagionous prior to this)


Therapeutic managem


Clubfoot - correct answer ✔Foot is twisted out of its normal shape or position


Incidence and etiology
-incidence is 1 per 1,000 live births
-males are affected twice as often as females
-50% of cases are bilateral
-exact cause is unknown
--may be caused by arrested fetal development during first trimester when foot
is formed
-genetic predisposition


Patho
-can be unilateral or bilateral
-foot is pointed downward and inward in varying degrees
-affected foot is rigid, fixed, and difficulty to move
-achilles tendon is shortened, calf muscle is thin and atrophic, and foot is
small


Diagnosis
-made at birth on basis of visual inspection
-x-ray/MRI can be used to confirm degree and severity of deformity

, Therapeutic management
-goal
--painless, plantigrade, functional foot
-3 phases of treatment
--correction
--maintenance
--follow-up
-treatment is started as soon as possible after birth
-Ponseti method of serial casting
-failure to achieve normal alignment indicates the need for surgical
intervention


Nursing management
-education
-parental support
-facilitation of normal development
-skin and circulatory status


Osteogenesis Imperfecta - correct answer ✔-Brittle bone disease
-connective tissue disorder characterized by distributed formation of periosteal
bone
-inherited disease, usually in an autosomal dominant pattern
-varying degrees


Clinical manifestations
-severe bone fragility and multiple fractures

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