Health Promotion and Maintenance
49. Which would be an abnormal finding when doing a well-child checkup on a 1-week-old infant?
Health Promotion and Maintenance
49. Which would be an abnormal finding when doing a well-child checkup on a 1-week-old infant?
. An audible "clunk" during the Ortolani test.
. Symmetrical gluteal folds when the infant is held upright.
. Negative Barlow test.
. Symmetrical knee height when the infant is supine.
Test-Taking Tip
Note the key words "abnormal findings." Recall that, when investigating hip dislocation, symmetrical findings are normal, which eliminates Answers 2 and 4. Next, recall that positive Ortolani and Barlow tests are pathologic for developmental dysplasia of the hip, which makes Answer 1 the only correct response.
Content Area: Child Health, Musculoskeletal; Integrated Process: Nursing Process, Assessment; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/System Specific Assessments
Health Promotion and Maintenance
.
Answer 1 is correct because an audible, low-pitched, "clunk" during the Ortolani test is caused by the sound of the femur head exiting or entering the acetabulum, indicating hip dislocation. Answer 2 is incorrect because symmetrical gluteal and thigh folds are negative signs of hip dislocation. Asymmetry would indicate dislocation of the hip. Answer 3 is incorrect because a positive Barlow test would indicate hip dislocation. Answer 4 is incorrect because asymmetry of the knees while the infant is in the supine position would indicate hip dislocation.