Chapter 15 - immunization + circumcision

Question 1

CI for circumcision

Answer 1

• preterm
• genitourinary defect
• risk for bleeding (did not admin vit K yet)
• compromising disorders like resp distress syndrome

Question 2

risks of circumcision

Answer 2

• hemorrhage
• infection
• adhesion
• pain

Question 3

actions before surgical procedure

Answer 3

• vit K
• consent
• no formula feed 2-3 hr before
• yes breast feed prior
• urinate prior
• acetaminophen prior
• have bulb nearby

Question 4

gomco or mogen clamp

Answer 4

• requires petroleum gauze at end of penis
• if penis adheres, then soak
• do NOT pull off
• heals w/in 2 wks

Question 5

post care for circumcision

Answer 5

• assess penis Q15 min for 1st hour, then Q2-3 hr
• acetaminophen Q4-6 hr
• neonate should void w/in 24 hr

Question 6

plastibell

Answer 6

stays on penis

• ring falls off in 7-10 days
• do not remove
• do not apply lube> incr risk for displacement

Question 7

periods of reactivity

Answer 7

periods of adjustment that occurs in first 6-8 hr of life

Question 8

first period of reactivity

Answer 8

newborn is alert, exhibits exploring activity

• makes sucking sound
• rapid HR (160-180) that stabilizes to 110-120 in 30 min
• rapid RR

Question 9

period of relative inactivity

Answer 9

quiet, rest, sleep

• HR + RR decrease
• 60-100 min post birth

Question 10

second period of reactivity

Answer 10

newborn reawakens

• responsive
• gags + chokes on mucus that has accumulated in mouth
• 2-8 hr after birth
• lasts 10 min to several hours