When assessing a newborn with clubfoot, the nurse should be aware of an increased association with which othe… - RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Child Health Nursing (Pediatrics)

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2015

Explanation

Newborns with clubfoot (talipes equinovarus) have a documented increased incidence of Developmental Dysplasia of the Hip (DDH).
This association is often attributed to "packaging problems" where intrauterine crowding or restricted fetal movement contributes to both deformities.
Due to this link, standard practice dictates that all infants diagnosed with clubfoot must undergo a thorough hip examination to screen for DDH.

Option A: While congenital heart defects can co-occur with clubfoot, especially as part of a broader genetic syndrome, it is not the most common or directly linked orthopedic association.
Option C: Cleft lip and palate is a midline facial defect with a different embryological origin from clubfoot. A direct association is not typical unless a specific genetic syndrome affecting multiple systems is present.
Option D: Gastrointestinal atresia involves the malformation of the digestive tract. It has a different developmental pathway and no established common association with clubfoot, which is a musculoskeletal deformity.

Clinical Relevance

Nursing practice connection: Knowing Comorbidities associated with clubfoot helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The nurse's role in the initial newborn assessment is critical for identifying both clubfoot and signs of DDH (e.g., asymmetrical skin folds, limited hip abduction, leg length discrepancy).
Early detection and treatment of DDH with methods like a Pavlik harness are highly effective and can prevent the need for more invasive surgery and long-term complications like limping or premature arthritis.
What if? If an infant with clubfoot also has other anomalies like a heart murmur or unusual facial features, the nurse should suspect a potential underlying genetic syndrome (e.g., Trisomy 18) and ensure the healthcare team initiates a more comprehensive genetic workup.

How to Approach the Question

First, identify the primary condition in the question: clubfoot in a newborn.
The question asks for a known 'increased association,' which points to a recognized comorbidity.
Consider the nature of clubfoot: it's a musculoskeletal deformity often linked to in-utero positioning.
Evaluate the options based on this understanding. Developmental Dysplasia of the Hip (DDH) is also a musculoskeletal condition that can be caused by similar in-utero mechanical forces ('packaging').
The other options (cardiac, facial, GI) involve different body systems and embryological pathways, making them less likely to be the primary associated condition in an otherwise healthy infant.
Select the option with the strongest and most direct clinical link, which is DDH, due to the shared etiology and established screening protocols.

Concept Tested & Keywords

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