ASSESSING FOR

PAIN MANAGEMENT

PAIN

Non-pharmacologic management:

Behavioral signs: crying,

whimpering, highpitched, shrill cry, flexing and adducting the upper body and lower limbs
(in an attempt to withdraw from painful
stimulus)
Facial expressions:
grimacing, eye squeeze,
brow contraction, a taut
and quivering tongue,
open mouth

Swaddling

Nonnutritive sucking

Skin-to-skin contact

CIRCUMCISION
CARE

Pharmacologic Management: Operative

Local anesthesia

Topical anesthesia

Acetaminophen (Non-opioid)
Morphine and fentanyl (Opiod)
Pharmacologic Management:
Post-Operative

Around-the-clock dosing or use of a

continual drip of opioid, such as
Ketorolac (Toradol)

Acetaminophen

Reference:
Lowdermilk, D. & Perry S. (2013). Maternity &
Womens Health Care (8th ed.). St. Louis: Mosby.

LISA C., STUDENT NURSE

Kapiolani Commnity College
Nursing Program
Spring 2014

Circumcision is the
excision of the
prepuce (foreskin) of
the penis, exposing
the glans

How to Care for a Circumcised Newborn at Home

CHECK FOR BLEEDING

OBSERVE FOR URINATION

Check circumcision for

change.

Check to see that the infant

bleeding with each diaper

circumcision site at least every

4 hours.

Infant should have a wet diaper 2

to 6 times per 24 hours the first

gentle pressure with a

1 to 2 days after birth, then 6 to

folded sterile gauze

10 times per 24 hours after 3 to

square. If bleeding does

4 days.

not stop with pressure,

notify primary health care

warm water to remove urine &

feces. Apply petrolatum to the
glans w/ each diaper change.

on the circumcised area.

(5 to 6 days)

Glans penis is dark red after cir-

for 2 to 3 days. Do not attempt

to remove it.

Redness, swelling, discharge, or

odor indicates infection. Notify
the primary health care provider!

Apply the diaper to prevent

pressure.

with yellow exudates in 24 hours,

which is normal and will persist

Use soap only after the

circumcision is healed

CHECK FOR INFECTION

Wash the penis gently with

cumcision, then becomes covered

NOTE:: Remember to always

wash your hands before
touching the newly
circumcised penis, to prevent
infection

Change the diaper & inspect

urinates after being circumcised.

If bleeding occurs, apply

provider.

KEEP AREA CLEAN

PROVIDE COMFORT

Circumcision is painful. Handle

the area gently.

Provide extra holding, feeding

& opportunities for
nonnutritive sucking for 1-2
days.