The nurse is caring for a neonate diagnosed with congenital hip dysplasia. When examining a newborn for dysplasia of the hip, the nurse would assess for which of the following?

Explanation

• Ortolani sign assists in detecting congenital hip dysplasia (also known as "developmental hip dysplasia"). While the infant lies flat, flex the hips and knees to 90 degrees. Place the index fingers over the greater trochanter of the femur and your thumb on the internal side of the thigh over the lesser trochanter. Abduct the hips while applying upward pressure over the greater trochanter and listen for a clicking sound.

• A clicking or clunking sound is a positive Ortolani sign and occurs when the femoral head relocates into the acetabulum. Normally, no sound should be heard.

Incorrect options:

• Assymetrical gluteal folds would be noted in congenital hip dysplasia.

• Trendelenburg's sign is noted when the child stands on the affected hip and the pelvis tilts downward on the opposite side. This is a sign of weak abductor muscles.

• A characteristic limp would be noted in the ambulatory child, not an infant.

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