Final answer:
After addressing the primary concern about the diaper rash, the APRN should evaluate the significance of asymmetrical gluteal folds, potentially indicative of developmental dysplasia of the hip (DDH), with an orthopedic evaluation or ultrasound of the hips being the next steps in diagnosis and treatment.
Step-by-step explanation:
When a mother brings in her 4-month-old infant to an urgent care clinic with concerns about a possibly infected rash in the diaper area and asymmetry of the gluteal folds is observed, the APRN (Advanced Practice Registered Nurse) initially focuses on determining the etiology of the rash. However, after addressing the primary concern about the rash, the APRN should also evaluate the significance of the asymmetrical gluteal folds, which can be a sign of developmental dysplasia of the hip (DDH). This condition is a concern in infants and can lead to further complications if not addressed. The APRN should refer the infant for an orthopedic evaluation or an ultrasound of the hips to ensure appropriate diagnosis and treatment. Additionally, parental education about the condition, its implications, and potential treatment options is essential for comprehensive care.