Newborn Circumcision and Care Education
Patient and Family Information
This patient was born prematurely at 30 weeks gestation and has been at the hospital for almost two months. His parents are both married, in their 20s and this is their first baby together. The mother of this baby tested positive for marijuana use and has been observed by the nursing staff as “acting high” when at the hospital visiting her son. It has also been reported that the parents eat edibles while at the hospital visiting their son. However social services investigated the family and determined that it was safe for the baby to go home with them. The parents both work full-time during the day so they say that they are unable to visit often. Usually they visit for
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Patient will verbalize five observations, which would warrant calling the doctor.
Breastfeeding Teaching Plan Outline
1. Explain what circumcision is and show picture:
a. Circumcision is a procedure in which the foreskin or the tissue that surrounds the head of the penis is cut off. (Mayo Foundation, 2012)
2. Provide the following education to parents on the pros and cons of circumcision:
a. Pros: Protects against urinary tract infections, prevents infections under the foreskin, decreases the risk of getting some sexually transmitted diseases (STDs) but does not prevent STDs (Schmitt, 2014). Circumcision also lowers the risk of penis cancer, and keeps appearance “like other boys” (Schmitt, 2014). One study found that circumcision significantly decreased the incidence of phimosis, adhesions, and inflammation (American Academy of Pediatrics, 2014). However there are not enough benefits to outweigh the potential complications for it to be
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Cons: Problems that may occur are infections, bleeding gangrene, and scarring (Schmitt, 2014). According to one study there is a 1 in 500 chance of circumcised newborns experiencing a serious side effect (Schmitt, 2014). The circumcision procedure causes pain to your baby and the penis will be tender for a few days following the procedure. During the procedure the penis is numbed with injected lidocaine and the baby is given sugar water throughout the procedure to help with the pain but it does not completely eliminate pain for your baby. Some insurance companies do not cover the cost (Schmitt, 2014). A study found that the mean payment for circumcision was $285 for neonatal and $1885 for postnatal circumcision (Hart-Cooper & Tao, 2014).
3. Inform and prepare parents of what to expect after the circumcision procedure.
a. Immediately after the procedure:
i. There may be a drop of blood in the diaper immediately after the procedure (Schmitt, 2014). ii. The incision is red and tender at first but should be minimal by the third day (Schmitt, 2014). iii. Comfort your baby with skin to skin contact, soft voice, feeding and Tylenol for pain. (Untitled illustration of a PlastiBell circumcision, 2014)
b. Seven to 14 days after the procedure:
i. The PlastiBell ring should fall off by 14 days, 10 days is the average (Lowedermilk &Perry,