This lesson was prepared for Nursing and Midwifery Students for the requirement of having necessary knowledge and skills related to surgical patients

1. College of Medicine and Health Sciences
Faculty of Nursing and Midwifery
Mohamed Mussa Abdilahi
Lecturer
Introduction to Perioperative Nursing
and
Midwifery Care

2. Lesson One
Introduction to Perioperative Midwifery Care
Perioperative Nursing:
It is a term used to describe the nursing/midwifery care
provided in the total surgical experience of the patient,
including what occurs before, during and after the actual
operation
1. Preoperative phase Assessment, preparation
2. Intraoperative phase Anesthesia, Surgery
3. Postoperative phase Pos-care, follow up

3. Lesson One
Introduction to Perioperative Midwifery Care
Post-operative
Phase
Begins with the decision to perform surgery and
continues until the client has reached the operating
area.
Preoperative
Phase
Intra-operative
Phase
Begins with admission to the recovery area and continues
until the client receives a follow up evaluation at home, or
is discharged to a rehabilitation unit.
Includes the entire duration of the surgical
procedure, until transfer of the client to the recovery
area.

4. Lesson One
Introduction to Perioperative Midwifery Care
Perioperative Skills:
 Assessment
 Communication
 Critical thinking
 Technical skills

5. Lesson One
Introduction to Perioperative Midwifery Care
Functions of a Perioperative Nurse and Midwife:
1. Advocate
2. Protector
3. Teacher
4. Change agent
5. Manager of client care

6. Lesson One
Introduction to Perioperative Midwifery Care
Types and proposes of surgery can be:
1. The reason for surgery
2. The urgency for surgery
3. The degree of risk of surgery
4. The anatomic location of the surgery
5. The extent of the surgery required

7. Reason for surgery
Category Description Surgical procedure
Diagnostic Performed to determine the origin and
cause of a disorder or the cell type for
cancer.
 Breast biopsy
 Exploratory laparotomy
Curative Performed to resolve a health problems
by repairing or removing the cause
 Cholecystectomy
 Mastectomy
 Hysterectomy
 Appendecectomy
Restorative Performed to improve a clients
functional ability
• Total knee replacement
• Finger re-implantation
• Total hip replacement
Palliative Performed to relieve symptoms of a
disease process, but does not a cure
• Colostomy
• Nerve root resection
Cosmetic Performed primarily to alter or enhance
personal appearance
• liposuction
• Revision of scars
• Rhinoplasty
• Cleft palate repairs

8. Urgency of the surgery
Category Description Surgical procedure
Elective Planning for a correction of non
acute problem
• Cataract removal
• Hernia repair
• Hemorrhoidectomy
Urgent Requires timely intervention, may be
life threatening if treatment is
delayed more the 24—48 hours
• Intestinal obstruction
• Bladder obstruction
• Kidney/urethral stone
• Bone fracture
• Eye injury
Emergent Requires immediate intervention
because of life threatening
consequence
• Gun shot or stab wound
• Sever bleeding
• Abdomen aortic aneurysm
• Appendectomy

9. Types of Elective Admissions for Surgery
Ambulatory Surgery/ Same-Day Surgery :
 Is a surgery that does not require an overnight hospital stay
 Term outpatient arises from the fact that surgery patients may
enter and leave the facility on the same day
 Go home the day of the surgery
Early Hospital Admission:
 Patient comes in early (night before or earlier)
 Usually patients with complex medical issues, and increased
risk for poor surgical outcomes

10. Types of Elective Admissions for Surgery
Example of Ambulatory Surgery
Teeth extraction
 Circumcision
 Cyst removal
 Tubal ligation

11. Degree of Risk
Category Description Surgical procedure
Minor Procedure with out significant risk
often done under local anesthesia
Involves minimal complications &
blood loss
• Incision/ drainage
Major Procedure of great risk usually larger
and more extensive than a minor
procedure
• Mitral valve replacement
• Kidney transplant

12. Extent of Surgery
Category Description Surgical procedure
Simple Only the most overly affected areas
involve in surgery
• Simple partial mastectomy
Radical Extensive surgery beyond the area
obviously involved , is directed at
finding a root of cause
• Radical hysterectomy

13. Anatomical location of the surgery
Neurologic surgery Brain, spinal cord • Craniotomy
• Burr hole
Obstetric,
gynecological
surgery
Uterus, ovaries, fallopian tubes,
cervix
• Caesarian section
• Hysterectomy
• Myomectomy
Genitourinary
surgery
Kidney, ureters, urinary
bladder, urethra
• Nephrectomy
• Cystoscopy
Cardiac surgery Heart • Mitra valve replacement
Thoracic surgery Lungs • Thoracotomy
Orthopedic surgery Bones • ORIF humerus
Breast surgery Breast • Mastectomy

14. Surgery urgency, purpose of surgery and to the
degree of risk