Ch. 28: Developmental Dysplasia of the Hip (DDH) Flashcards Preview

ATI Pediatrics-MJ > Ch. 28: Developmental Dysplasia of the Hip (DDH) > Flashcards

Flashcards in Ch. 28: Developmental Dysplasia of the Hip (DDH) Deck (30):
1

What is acetabular dysplasia?

Delay in acetabular development

2

What is subluxation ?

Incomplete dislocation of the hip

3

What is dislocation?

Femoral head does not have contact with the acetabulum

4

What are signs of DDH in an infant?

-Assymetry of gluteal and thigh folds
-Limited hip abduction
-Shortening of the femur
-Positive ortolani test
-Positive barlow test

5

What is the ortolani test?

Hip is reduced by abduction (sign of DDH in infant)

6

What is the barlow test?

Hip is dislocated by adduction (sign of DDH in infant)

7

What are signs of DDH in the child?

-One leg shorter than the other
-Positive Trendelenburg sign
-Walking on toes on one foot
-Walk with a limp

8

What is the trendelenbury sign?

While bearing weight on the affected side, the pelvis tilts downward (sign of DDH in child)

9

In DDH patients, what should be done at 2 weeks of age? Why?

Ultrasound; to determine the cartilaginous head of the femur

10

What can diagnose DDH in infants older than 4 months of age?

X ray

11

What do DDH patients newborn-6 months wear?

Pavlik harness
-Maintain harness in place for 12 weeks
-Check straps every 1-2 weeks for adjustment
-Perform neuromuscular skin integrity checks

12

What is client teaching about the Palvik harness (newborn-6 m)

-Teach fam not to adjust straps
-Teach fam how to place harness if removal is prescribed
-Teach fam about skin care (use an undershirt, knee socks, assess skin, massage skin under straps, avoid lotion and powder, place diaper UNDER straps)

13

What cast is used when adduction contracture is present?

Bryant traction or hip spica cast

14

What is the Bryant traction?

-Hips flexed at 90 degree angle with butt raised off bed

15

What are nursing action for Bryant traction?

-Neurovascular checks
-Maintain traction (ropes, boots, pulleys, and weights)
-Ensure client maintains alignment
-Skin care

16

What are nursing actions for the hip spica cast?

-Needs to be changed to accommodate growth
-Maintain cast
-Frequent neurovascular check
-ROM with unaffected extremities
-Skin integrity (especially diaper area)
-Assess pain
-Evaluate hydration
-Assess elimination status daily

17

How should casts be positioned?

On pollows

18

Keep casts elevated until __

Dry

19

What helps allow for drying?

Encourage frequent position

20

How do we handle the cast when it is still wet?

Handle casts with the palm of hand until dry

21

Use a waterproof barrier around the genital opening of the ____ to prevent soiling with urine or feces

Spica cast

22

What happens at 6 months-2 years?

Surgical closed reduction with placement of hip spica cast

23

What are complications of post op?

Atelectasis
Ileus
Infection

24

What are effects of immobilization complications?

Decreased muscle strength
Bone demineralization
Altered bowel motility

25

What are effects of casting complications?

Skin breakdown
Neurovascular alterations

26

Infection: What would be changes in neuromuscular status?

Numbness
Tingling
Decreased mobility
Sensation
Cap refill

27

Infection: What kind of diet helps promote adequate hydration?

High fiber

28

Infection: Reposition the child ____

Frequently

29

The nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother ass the nurse why a Pavlik harness is not being used. Which of the following responses by the nurse appropriately addresses the mothers question?

A. The Pavlik harness is used for children with scoliosis, not hip dysplasia.
B. The Pavlik harness is used for school-age children
C. The Pavlik harness cannot be used for your child b/c her condition is too severe
D. The Pavlik harness is used for infants less than 6 months of age

D

30

A nurse is caring for a preschool-age child. Which of the following assessments should the nurse use to assess for development dysplasia of the hip?

A. Barlow test
B. Trendelenburg sign
C. Manipulation of foot and ankle
D. Ortolani test

B