Hypospadias and epispadias are congenital anomalies of the penis that result in the incomplete development of the anterior urethra. In hypospadias, the urethral opening is located along the underside of the penis, near the tip. In epispadias, the urethral opening is on the upper surface (dorsum) of the penis.
The incidence of this defect in the United States is approximately 3.2 in 1,000 live male births or about 1 in every 300 male children. The cause of this defect is unknown but is associated with genetics, low birth weights, and by race/ethnic background (more common in whites, Italians, and Jews). Chordee, an abnormal curvature of the penis, is usually linked with hypospadias. Other associated anomalies include undescended testes, an inguinal hernia, and Wilms tumor.
The goal of treatment of this anomaly is to reconstruct a straight penis with a meatus close to the normal anatomic location. Usually, the surgical repair is recommended to be done in the early year of life to prevent psychological trauma. Currently, the recommended age for urethroplasty (hypospadias/epispadias repair) is between 3 to 12 months of age and for orthoplasty (chordee repair) is during the first year of the child.
Nursing Care Plans
Major nursing care plan objectives for the child with hypospadias or epispadias include improving the child’s physical appearance, ensuring a positive body image, providing relief of pain and discomfort, decreasing parental anxiety, and absence of complications (bleeding, infection, catheter obstruction and sexual dysfunction).
Here are four (4) nursing care plans (NCP) and nursing diagnosis (NDx) for hypospadias and epispadias:
Acute Pain
Nursing Diagnosis
May be related to
Possibly evidenced by
- Verbalization of pain
- Crying
- Irritability, restlessness
- Distractive behavior
- Changes in vital signs
Desired Outcomes
- Child will experience decreased pain as evidenced by infrequent crying episodes and exhibit normal sleeping pattern.
| Nursing Interventions | Rationale |
|---|---|
| Assess location, characteristics, onset, duration, frequency, location, and severity of pain; Observe for verbal and nonverbal cues. | Provides data about the description of pain which can be used as a guideline for analgesic therapy. |
| Maintain a position of comfort; Properly set the catheter to avoid tension and kinking. | Promotes comfort and avoids pain due to pulling on or manipulating catheter. |
| Encourage use of relaxation techniques. | Promotes rest and refocus attention thus decreases discomfort. |
| Apply ice compress as indicated. | Relieves pain and decreases edema. |
| Administer analgesic (e.g., Tylenol) as ordered. | Lessens pain and promotes rest which reduces stimuli and pain. |
| Educate parents that medications will prevent pain and restlessness and allow for healing. | Provides information about the need for pain medications for child’s comfort. |
Recommended Resources
Recommended nursing diagnosis and nursing care plan books and resources.
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NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses as reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.
Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of it’s evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions show how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.
Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.
Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.
Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!
All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.
See also
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database MUST READ!
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch. - Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans