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CIRCUMCISION Circumcision is a surgical procedure in which the prepuce (foreskin) of the penis is separated from the glans, and  a portion is excised. This elective procedure is performed in the United States based on parental choice for reasons  related to hygiene, religion, tradition, social norms, and culture. It is usually performed at 12–24 hr of age or when the  infant is considered physically stable. Frequency of this procedure has declined in recent years to approximately 62%. NEONATAL ASSESSMENT DATA BASE Circulation Vital signs WNL, no signs of cold stress Administration of vitamin K Food/Fluid Weight at least 2500 g (5 lb 8 oz) Safety Temperature WNL Free of congenital anomalies; no family history of bleeding disorders or history of “proud flesh” scar formation  (especially in black families) Sexuality Infant full-term (based on Dubowitz criteria) Genitalia normal, with no evidence of hypospadias or epispadias; testes descended, and scrotal sac free of hydrocele;  prepuce, still developing at birth, normally nonretractable DIAGNOSTIC STUDIES CBC:  Rules out presence of anemia. Clotting Studies:  Identify coagulation problems. NURSING PRIORITIES 1. Provide parents with sufficient information to make an informed choice. 2. Promote comfort and healing. 3. Identify and minimize postoperative complications. 4. Instruct parent(s) in proper care of circumcised infant. DISCHARGE CRITERIA 1. Void appropriately past procedure. 2. Free of complications. 3. Parent(s) understand care needs and signs/symptoms requiring further evaluation. NURSING DIAGNOSIS: KNOWLEDGE deficit [Learning Need], regarding surgical  procedure, prognosis,  and treatment May Be Related To: Lack of exposure, misinterpretation, unfamiliarity with information  resources Possibly Evidenced By: Request for information, verbalization of concerns/misconceptions,  inaccurate follow- through of instructions DESIRED OUTCOMES/EVALUATION  Make informed decision.
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CRITERIA—PARENT(S) WILL: Demonstrate proper technique of care following procedure. Verbalize understanding of signs of complications. ACTIONS/INTERVENTIONS RATIONALE Independent Ascertain parents’ understanding of the  Provides a basis for discussion and identifies need  procedure. Determine cultural/religious influences. for further information. While cultural/religious  beliefs may dictate circumcision be performed, some  studies have shown that many women do not know  the meaning of the word or whether their husbands  are circumcised.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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