DNP 643 Module 1 Case Study 1: Care of the Newborn (Developmental Dysplasia of the Hip) Example

Reviewed by Ingrid Vasterling, MSN, RN Arizona State University Updated October 2026

This DNP 643 Module 1 sample answers Case Study 1, the newborn case in Developmentally Based Care of the Well Child, a pediatric primary care course in ASU's Doctor of Nursing Practice. ASU DNP 643 opens five case studies across the summer term, each tied to that week's age group and answered with referenced articles, followed by a reply to a classmate. Week 4 covers birth to 30 days, and this composite case is a 2-week-old firstborn girl, born breech, whose left hip feels unstable on examination. The response explains her risk factors, what the Ortolani and Barlow findings mean, when ultrasound and orthopedic referral should happen, how a Pavlik harness works and what the parents need to hear, then replies to a classmate on universal ultrasound screening.

CourseDNP 643 Developmentally Based Care of the Well Child
ModuleModule 1
Paper typeCase study response with peer reply
LengthAbout 573 words
FormatDiscussion post with APA 7 citations
SchoolArizona State University
ProgramDoctor of Nursing Practice
UpdatedOctober 2026

Free sample paper for DNP 643 Module 1

1

Case Study 1: A Click at the Two-Week Visit

A Click at the Two-Week Visit: Recognizing and Referring Developmental Dysplasia of the Hip in a Breech-Born Newborn Girl

The Case

Baby girl M., 15 days old, comes to her first clinic visit after the newborn period. She is her parents' first child, born at 39 weeks by cesarean delivery for frank breech presentation. Her newborn hip examination in the hospital was documented as normal. Today she is feeding well and has regained her birth weight. On examination, the left hip produces a palpable clunk with the Barlow maneuver and a reduction with Ortolani. Thigh creases are slightly asymmetric. The right hip is stable.

Case Study Response

Risk Factors

M. carries the three classic risk factors for DDH, the abbreviation used throughout this response: female sex, firstborn status and breech presentation in the third trimester. The AAP clinical report notes that breech positioning is the strongest single risk factor and recommends imaging for breech infants even when the examination is normal (Shaw et al., 2016). Her normal hospital examination does not rule out the condition, since hip instability can appear or be missed in the first days.

What the Examination Means

The Barlow maneuver tests whether a reduced hip can be pushed out of the socket by adduction and gentle posterior pressure; a positive test means the hip is dislocatable. The Ortolani maneuver tests whether a dislocated hip can be reduced by abduction and lifting the greater trochanter; a positive test means the hip was dislocated and relocates. M. has a hip that moves out of and back into the socket, an unstable hip. Asymmetric creases are a soft finding and common in normal infants, but they support the concern here. A high-pitched click without a sense of movement is usually benign; a clunk of the femoral head is not (Kliegman et al., 2024).

Plan

A positive Ortolani or Barlow test after the newborn period calls for prompt referral to a pediatric orthopedic specialist rather than waiting for imaging (Shaw et al., 2016). I would refer M. this week. Ultrasound is the imaging study of choice before about 4 to 6 months, when the femoral head is still cartilage, and the orthopedic team will usually obtain it. Treatment for an unstable hip in a young infant is most often the Pavlik harness, which holds the hips flexed and abducted so the head sits in the socket and the acetabulum can deepen. Success rates are high when treatment begins early (Shaw et al., 2016).

Anticipatory Guidance

I would explain to the parents that the hip is loose, not broken, that early treatment usually works and that the harness is worn nearly full time at first. Swaddling should allow the legs to bend up and out at the hips rather than wrapping them straight, which can harm developing hips (Clarke, 2014). Because she has a hip concern, I would also make sure her car seat and carrier allow the legs to spread.

What this page is doingThe response answers the case in four parts that a primary care clinician needs: why this infant is at risk, what the findings mean, what to do this week and what to teach, each tied to the AAP clinical report.
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Reply to a Classmate (On Universal Ultrasound)

Jasmine, you asked why the United States does not ultrasound every newborn hip. The AAP approach is selective: examine every infant at every visit through walking age and image those with risk factors or abnormal findings, because universal ultrasound in the first weeks finds many immature hips that would resolve and leads to overtreatment (Shaw et al., 2016). Do you think a clinic serving many breech deliveries should track whether those 6-week ultrasounds actually get done?

What this page is doingThe reply explains the reasoning behind the screening policy and turns it into a practical question about follow-through.
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References

Clarke, N. M. P. (2014). Swaddling and hip dysplasia: An orthopaedic perspective. Archives of Disease in Childhood, 99(1), 5-6. https://doi.org/10.1136/archdischild-2013-304143

Kliegman, R. M., St. Geme, J. W., Blum, N. J., Tasker, R. C., Wilson, K. M., Schuh, A. M., & Mack, C. L. (Eds.). (2024). Nelson textbook of pediatrics (22nd ed.). Elsevier.

Shaw, B. A., Segal, L. S., & Section on Orthopaedics. (2016). Evaluation and referral for developmental dysplasia of the hip in infants. Pediatrics, 138(6), Article e20163107. https://doi.org/10.1542/peds.2016-3107

Reading the DNP 643 Module 1 assignment instructions

The first of five case studies in DNP 643 falls in Week 4, Care of the Newborn/Neonate, the module on birth to 30 days. Faculty post the case when the week opens on Sunday. Your referenced response, in APA format, is due Wednesday night, and by Friday you add a reply to at least one classmate. The syllabus describes the case studies briefly, so read the Canvas questions closely and answer each one by name. Newborn cases in a well-child course usually test whether you can recognize a finding at a routine visit, judge its urgency and explain it to new parents, which makes risk, examination, timing and teaching the natural outline for a response.

Inside the DNP 643 Module 1 example

The post restates the case briefly so a classmate can follow it, then answers under four headings. The risk factor section names all three classic risk factors and explains why a normal hospital examination does not settle the question. The examination section defines each maneuver, what a positive result means and how a benign click differs from a clunk. The plan section sets the timing of referral and imaging, explains why ultrasound is preferred at this age and describes the harness. The guidance section covers what parents fear, swaddling and equipment. The closing reply answers a classmate's question about universal ultrasound with the reasoning behind the selective approach. Two articles and a textbook support the answer.

DNP 643 Module 1 rubric: what earns full marks

Case Study 1 is worth 10 points, and the five cases together make up 30% of the DNP 643 grade, more than either exam. Responses to newborn cases tend to be credited for correct interpretation of examination findings, attention to risk factors, a plan with a clear time frame for referral or recheck, guidance a new parent can act on and current references in APA format. The required reply should add a point or a question rather than agreement. Common deductions include describing the condition in general without applying it to the infant, offering reassurance that the findings do not support and citing websites in place of professional society reports.

DNP 643 Module 1 help from the desk

Write for this infant and this visit. A response that explains hip dysplasia well but never says when to refer misses the point of a primary care case. Define each examination maneuver in your own words, because confusing them is a common error. Address what the parents fear and what they will do at home, including swaddling. Use the AAP clinical report as your anchor source. Keep your reply to a classmate specific: a fact, a source or a question. Strip identifying details from anything drawn from clinical. If you share the case and questions from Canvas with the desk, it can help you outline a response that covers each one.

Write yours, or have the desk draft it

This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.

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DNP 643 Module 1 questions, answered

Where can I find a free DNP 643 Module 1 sample paper?

A full DNP 643 Module 1 sample is on this page: a newborn case study response on developmental dysplasia of the hip in a breech-born girl, with a reply to a classmate.

Which babies are more likely to have hip dysplasia?

Breech presentation in the third trimester, female sex, a family history of DDH and, less strongly, firstborn status and conditions that crowd the uterus.

What is the difference between the Barlow and Ortolani tests?

Barlow checks whether a hip can be pushed out of the socket; Ortolani checks whether a dislocated hip can be moved back in. Either positive result needs referral.

How are DNP 643 case studies graded?

Five case studies are worth 10 points each and 30% of the grade; responses are due Wednesday and a reply to a classmate by Friday.

Why does swaddling matter for hip dysplasia?

Wrapping the legs straight and together can stress developing hips; safe swaddling lets the legs bend up and out at the hips.