Nursing Paper on Teaching Plan for a Post-Circumcision Care of an Infant

Teaching Plan for a Post-Circumcision Care of an Infant

Background

Circumcision is the surgical removal of the foreskin from the head of a male penis so as to expose its tip (Blank et al., 2012). Circumcision is commonly done to newborn boys; however, some traditional societies postpone the procedure until teenage hood. Adult circumcision is also becoming common in some parts of Africa communities following the sensitization campaign to reduce the risk of sexually transmitted infections (Matar et al., 2014). The removal of the foreskin in baby boys has been practiced as a cultural or religious ritual. However, some parents have also approved it due to its medical benefits to the boys. For example, circumcision is known to improve hygiene and lowers risk of urinary tract infection in babies. That notwithstanding, several medics have expressed their disapproval on the afterbirth boys circumcision. According the American Academy of Pediatrics (AAP) 2012 policy, circumcision is a ‘non-therapeutic’ procedure and thus, its discretion is left with the parents (Blank et al., 2012).

 Despite stating that the benefits of newborn circumcision outweigh the risk involved, AAP claims that there are no sufficient medical benefits to recommend it universally. Nonetheless, several parents all over the world have opted for afterbirth circumcision for their sons. In the United States, for example, approximately 55 to 65 percent of all newborn boys are subjected to circumcision within the first ten days of their lives (Matar et al., 2014). Therefore, it is necessary parents, who opt for infant circumcision for their sons, to be advised adequately on the required post-circumcision care. The following is a teaching plan that can be adopted to educate newly circumcised boys’ mothers prior to the boy’s discharge from hospital.

Objective

The teaching plan is meant to address some long-term and short term goals. In the short run, the mother should be able to wash the baby’s penis gently, observing the required attention to the incision. The mother should also be able to describe the normal and abnormal symptoms expected in the course penis healing. On the other hand, the long-term goal is to have the newly circumcised baby’s penis heal without infection or complication while causing minimum discomfort to the baby. This guide intends to ensure that the mother is well equipped with the necessary circumcision wound care skills before she takes her baby home.

Method

The teaching is geared for a mother whose son has undergone circumcision a few hours or days ago. Although there are different patient teaching methods that can be adopted in mother’s training, a demonstration and return-demonstration method appears more appropriate. First, it boosts the mother’s confidence in handling the delicate baby’s penis. Studies have shown that parents, especially new mothers, find it uncomfortable to handle the baby after surgery due to the perception of the pain involved. The teaching plan can be implemented using the following step by step procedures.

  1. The instructor should describe the nature of the penis, as it was before and after circumcision. Pictures or dummies for the two can be used during for demonstration. The instructor can also give brief and basic description of the circumcision procedure.
  2. The instructor should then explain on the changes expected as the penis heals, that is, stating what is normal and what is not. For instance, the newly circumcised penis should appear slightly swollen. However, increased reddish swelling that is accompanied by fever should be brought to the attention of a doctor. The baby should be able to urinate without any signs of pain or discomfort. Minor bleeding is also normal, but persistent or heavy bleeding might be a sign of complication, which calls for immediate doctor’s attention.
  3. The instructor should also state and explain the responsibilities of the mother during the healing process. For instance, the mother should change the baby’s diaper more frequently to avoid long contact of the incision and the stool or urine. Each diaper change should be accompanied by gentle cleaning of the penis and the replacement of bandage with new ones.
  4. The instructor should then demonstrate what he/she has described in step 2. This will involve placing the baby in the right position as the mother watches and proceeding with the cleaning process. Then instructor should then replace the bandage, that is, if the doctor had used gauze, applying a coat of petroleum jelly to prevent adhering. If the doctor had used a plastic ring in place of the bandage, then it should be left to drop off on its own
  5. The return – demonstration may be carried on immediately after the instructor’s step 3. However, this teaching plan recommends for a few minutes break for the baby. The mother can perform the return-demonstration procedure during the next scheduled diaper change.
  6. Give the mother any available relevant brochures for her reference.

Evaluation

The evaluation process begins with the return-demonstration of the diaper change and penis cleaning. The instructors are able to assess whether the mother is observing the cautionary measures so that the penis remains as clean and dry as possible and is being gentle enough so that the procedure is comfortable to the baby. The mother can also be requested to respond to various oral questions regarding the normal or alarming signs of a healing cut.

References

Blank, S., Brady, M., Buerk, E., Carlo, W., Diekema, D., Freedman, A., & Wegner, S. (2012). Circumcision policy statement. Pediatrics130(3), 585-586. http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-1989

Matar, L., Zhu, J., Chen, R. T., & Gust, D. A. (2014). Medical Risks and Benefits of Newborn Male Circumcision in the United States Physician Perspective. Journal of the International Association of Providers of AIDS Care (JIAPAC), 2325957414535975. http://jia.sagepub.com/content/early/2014/05/30/2325957414535975.abstract