A 6-month-old infant is being evaluated for developmental dysplasia of the hip (DDH). The nurse is preparing t…

Question

A 6-month-old infant is being evaluated for developmental dysplasia of the hip (DDH). The nurse is preparing to assist with the Ortolani test. Which nursing action is the MOST important safety consideration during this examination?

Accepted Answer

보기 2: Ensure gentle handling and avoid excessive force during hip manipulation

The Ortolani test requires gentle handling to avoid injury to the infant's developing hip joint. Other positions or excessive force can cause harm.

Answer

보기 1: Position the infant in a prone position to better visualize hip alignment

Answer

보기 3: Apply firm pressure to stabilize the pelvis throughout the examination

Answer

보기 4: Maintain the infant in a supine position with legs fully extended

Concept	Description	Key Nursing Implication
Developmental Dysplasia of the Hip (DDH)	Spectrum of hip instability, subluxation, or dislocation present from birth or developing in infancy.	Early detection via screening (Ortolani/Barlow) is crucial for non-surgical treatment (Pavlik harness).
Ortolani Test (Reduction maneuver)	Infant supine, hips/knees flexed 90°. Gentle abduction and lifting of thighs to feel/sound a "clunk" of reduction.	Must be performed gently to avoid injury. A positive test indicates a dislocated but reducible hip.
Barlow Test (Dislocation maneuver)	Infant supine, hips/knees flexed 90°. Gentle adduction and downward pressure on thighs to feel a "clunk" of dislocation.	Also requires gentle force. A positive test indicates a dislocatable but located hip.
Nursing Priority	Patient Safety & Injury Prevention	Gentle handling is paramount. Never use force. Ensure infant is calm and relaxed for accurate assessment.

Test	Ortolani Maneuver	Barlow Maneuver
Purpose	To detect an already dislocated hip that can be reduced.	To detect a dislocatable hip (located but unstable).
Action	Gentle abduction and anterior lifting of the flexed thigh.	Gentle adduction and posterior pressure on the flexed thigh.
Positive Sign	Palpable or audible "clunk" as femoral head reduces into acetabulum.	Palpable "clunk" or sensation as femoral head exits the acetabulum.
Common Age	Most reliable in infants < 3 months old (before soft tissues tighten).	Most reliable in infants < 3 months old.
Shared Principle	Key Point! Both require a relaxed infant and extremely gentle handling to prevent injury.

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A 6-month-old infant is being evaluated for developmental dysplasia of the hip (DDH). The nurse is preparing to assist with the Ortolani test. Which nursing action is the MOST important safety consideration during this examination?

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