NCP 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.