| Abstract | Dojka je parna žlijezda smještena na prsnom košu. Podlogu dojci daje mliječna žlijezda građena od 15 do 20 režnjeva, međusobno odvojenih masnim tkivom. Mliječni vodovi vode mlijeko iz žljezdanog tkiva do bradavice, a bradavica je okružena tamnije pigmentiranim tkivom. Režnjići i izvodni kanali mliječne žlijezde zrakasto su poredani oko areole. Veličina i oblik dojke ovise o konstituciji i genetskom nasljeđu. Po zastupljenosti malignih oboljenja kod žena je karcinom dojke na prvom mjestu, zbog čega je od velike važnosti pravovremeno otkrivanje i liječenje. Najčešće se javlja između 40 i 60. godine. Lokalizacija karcinoma najčešća je u gornjem lateralnom kvadrantu dojke. Simptomi i znakovi karcinoma dojke su bol, opipljiva kvržica, iscjedak iz bradavice, uvučena bradavica, naglašene vene na površini dojke i povećani limfni čvorovi u pazušnoj regiji. U dijagnosticiranju raka dojke koriste se: citološki pregled sekreta ili sadržaja dobivenog punkcijom dojke, tkivo dobiveno operacijskom biopsijom, fizikalni pregled kirurga, mamografija, galaktografija, kompjutorizirana tomografija, magnetska rezonancija, ultrazvuk dojke i tumorskim markeri dobiveni iz krvi bolesnice. Liječi se kirurški s dopunskom radiološkom, citostatskom ili hormonskom terapijom. Dugoročna prognoza ovisi o zahvaćenosti limfnih čvorova, broju zahvaćenih aksilarnih limfnih čvorova, veličini primarnog tumora, stupnju diferenciranosti tumora, kliničkom stadiju bolesti i dobi bolesnice. U liječenju karcinoma dojke surađuju kirurg, onkolog, radiolog, anesteziolog, psiholog i medicinske sestre. Medicinska sestra će pripremiti bolesnicu za operativni zahvat, skrbiti redovitim previjanjem o poslijeoperativnoj rani, analgeziji i svim ostalim njenim potrebama u poslijeoperativnom razdoblju, podučiti je vježbama dubokog disanja i vježbanja ruke na operiranoj strani nakon operativnog zahvata te nakon zarastanja rane provesti edukaciju bolesnice i članova njezine obitelji.
Cilj ovoga rada je prikazati ulogu medicinske sestre u provedbi zdravstvene njege bolesnice s karcinomom dojke u prijeoperacijskom, intraoperacijskom i postoperacijskom periodu. |
| Abstract (english) | The breast is a double skin gland located on the chest bone between the second and seventh rib, and between the chest bone and the middle axillary line. Base of the breast is made from 15 to 20 limbs, each separated by fatty tissue. Dairy lines lead from the glandular tissue to the nipple, and the nipple is surrounded by darker pigmented tissue. The laryngeal and exfoliating channels of the lactic gland are clustered around the areole. Size and form of breast depend on constitution and genetic inheritance. Breast cancer is the leading cause of dying in women, which is why is very important to detect it and cure it on time. It occurs between the ages of 40 and 60. It is mostly common to find it in upper right quadrant of breast tissue. Symptoms and signs of breast cancer are pain, tired nodule, nipple discharge, retracted nipple, intensified, pronounced veins on the surface of the breast, and increased lymph nodes in the armpit region. Breast chest is diagnosed by cytological examination of secretion or content obtained by breast puncture, operative biopsy, breast self-treatment, physical examination, mammography, galactography, computerized tomography, magnetic resonance imaging, breast ultrasound and tumor markers. It is treated with a surgical route with complementary radiological, cytostatic or hormonal therapy. Long-term prognosis depends on the extent of the lymph node involvement, the number of affected axillary lymph nodes, the size of the primary tumor, the stage of differentiation of the tumor, the clinical stage and the age of the patient. Breast cancer is co-operated by a surgeon, oncologist, radiologist, anesthesiologist, psychologist and nurse whose role is of great importance. The nurse will prepare the patient for the surgery, provide her with the support and necessary conversation, undertake deep breathing exercises and exercise on the operative side after surgery, and train the patient and her family members. The goal is to outline the role of a nurse in the preoperative, intraoperative and postoperative time. |
