patho
what is developmental hip dysplasia
The head of the femur is partially or completely displaced as the result of a shallow acetabulum; subluxation can be partial or complete
name at least 2 manifestations
•Limited abduction of the leg on the affected side
•One buttock appears higher than the other when the infant is prone
•Knee is lower on the side of dislocation
•Skin on the side of dislocation is looser
•limp
•When the infant is on the back with the knees and hips flexed, the thigh on the unaffected side can be pressed back until it almost touches the exam table; this can only be done partially in the affected leg
when is surgery performed
Surgery for infants more than 18 years old who don’t respond to treatment: open reduction or repair of the shelf of the hipbone – case applied after surgery to keep the femur in the correct position
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F is for friends who do stuff together
hasta la vista, baby
Terminator 2
contributing factors
contributing factors: hip malformation, joint laxity, breech position, maternal hormones
when is hip dislocation commonly discovered
Hip dislocation commonly discovered during periodic health exams when the infant is 1-2 years old
how often is the cast changed (in general)
q6wks
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is the pizza for you and me
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Mean Girls
this is most common in ________
7x more common in girls
true or false: one buttock appears higher than the other when the infant with developmental hip dysplasia is supine
false: One buttock appears higher than the other when the infant is prone
when is traction used
•Traction if the dislocation is severe or if it’s not detected until the child is walking: pulls the head of the femur down to the correct position and helps to overcome muscle spasms
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Karen
on your left
CA: TWS
what cultures are at high risk
high risk for developmental hip dysplasia in cultures where babies are wrapped snugly with the hips in adduction and extension
describe Ortolani's sign
Ortolani’s sign: HCP can feel and hear the femoral head move back into the acetabulum under gentle pressure
true or false: the hip is maintained in constant flexion and adduction for 4-8 weeks
false: Hips maintained in constant flexion and ABDUCTION for 4-8 wks to keep the head of the femur within the hip socket: provides constant pressure that deepens the acetabulum (which corrects the dislocation)
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Bubble buddy
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You
what cultures have a lower risk
lower risk when the infant is carried on the mother’s waist w the infant’s hips flexed and widely abducted
describe Barlow's test
When the infant is on the back with the knees and hips flexed, the thigh on the unaffected side can be pressed back until it almost touches the exam table; this can only be done partially in the affected leg
describe at least 4 measures for nursing care
•Note the posture and gait of older children and record observations
•Spica cast care: neuro assessment, firm, plastic-covered pillows under the curvatures for support,
•fracture pan for bedside toileting, HOB slightly elevated, pillows to elevate the head or shoulders of the body;
•Frequent position changes
•Don’t use the supporting bar between the legs as a lever when turning the child
•Support all body curvatures w pillows or sheet rolls
•Place the older child on the abd during mealtime to facilitate swallowing and self-feeding
•When a child in a body case is put on a fracture pan, support the upper back and legs on pillows so body alignment is maintained
•Place a strip of gauze beneath the cast before it’s applied; it’s gently moved bath and forth to relieve itching; if the strip becomes soiled, tie a clean one to the end of the soiled one and pull it through the cast to remove the soiled one
•Don’t give the child small toys; they could hide them in the cast
•Toys that can be used in prone position are best
•Referral for home health care may be made on discharge
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I'm proud
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what, like it’s hard?
Legally blonde