| Abstract | Rad na odjelu otorinolaringologije je vrlo specifičan. Sve je veći broj oboljelih od
malignih bolesti glave i vrata, koje su visoko povezane s konzumacijom duhanskih
proizvoda, alkohola te Humanim papiloma virusom. Glavno i najuspješnije liječenje uz
preduvjet ranog otkrivanja je operativni zahvat. Zbrinjavanje bolesnika nakon takvih
zahvata je specifično zbog opsežnosti zahvata, visokog rizika za postoperativne
komplikacije te zbog promjena koje bolesnik doživljava nakon zahvata. Najveći dio
sestrinskih intervencija usmjeren je na zadovoljavanje osnovnih životnih potreba
bolesnika te edukaciju bolesnika i njegovih bližnjih. Da bi sestre mogle zbrinjavati i
educirati bolesnika važno je da one nisu stigmatizirane. Sestre moraju znati da je i
traheotomija neophodna kod ovakvih zahvata i da je to najsigurniji način održavanja
dišnih putova otvorenima te da to olakšava disanje bolesniku i sestri skrb za
bolesnika. Neke od najčešćih poteškoća su vezane uz promjenu načina prehrane,
disanja, govora, obavljanja higijene, te nerijetko i velike promjene u izgledu. Takvi
zahvati zahtijevaju traheotomiju (koja je često doživotna), uvođenje nazogastrične
sonde, te ovisno o vrsti zahvata i oboljenja korištenje raznih implantata i pomagala
(A.O. sinteza mandibule, govorna proteza, razne vrste režnjeva za rekonstrukciju i
sl.). U liječenju pacijenata oboljelih od malignih bolesti gornjeg djela dišnog i
probavnog trakta sudjeluje tim stručnjaka: liječnik opće prakse, specijalist
otorinolaringolog, specijalisti nuklearne medicine, anesteziolozi, onkolozi, radiolozi,
logopedi, anesteziološki tehničari, medicinske sestre/tehničari instrumentari i odjelne
medicinske sestre. Većini bolesnika nakon liječenja najveći problem predstavljaju
narušeni self-image i poteškoće ili nemogućnost govora. Sestra je dužna educirati
bolesnika te ga u dogovoru s ostalim stručnjacima uputiti u daljnji postupak
rehabilitacije. U daljnjoj rehabilitaciji najčešće sudjeluju medicinske sestre, liječnici
opće prakse, specijalist otorinolaringolog, logoped te psiholog. |
| Abstract (english) | Work in the ENT department is very specific. There are an increasing number of
malignant diseases of head and neck area which are highly correlated to tobacco
consumption, alcohol consumption and HPV infection. The best possible way to treat
the head and neck tumors is an operation with the prerequisite of an early detection.
Taking care of patients after head and neck operations is very specific due to the
extensive operations, high risk of postoperative complications and the changes that
patient experience after the operation. Highest numbers of nurse interventions are
intended to meet basic life needs of the patients and to educate patients and their
families. It is important that nurses aren’t stigmatized so they could take care of the
patients and educate them. Nurses have to know that tracheotomy is necessary in
this type of procedures and that it’s the safest way to keep the airway open and to
easy the breathing for patient and doing the toilette of the airway. Some of the most
frequent difficulties are related with changing the way the patients eat, breathe,
speak, how they perform daily hygiene and the way they look. This types of
procedures require the tracheotomy (very often for the lifetime), inserting the feeding
tube, inserting different types of implants (metal plates after the A-O synthesis,
speech prosthesis, different types of flaps for reconstruction etc.). Different types of
specialties work together when they treat patients with tumors of upper respiratory
system and upper digestive tract; general practitioners, ENT specialists, nuclear
medicine specialists, anesthesiologists, oncologists, radiologists, speech therapists,
anesthesiology technicians, scrub nurses, department nurses. Inability to speech or
compromised self image is the greatest problem after the operation. Nurse is
obligatory to educate the patient and to send him for further rehabilitation with the
other specialists. Nurses, general practitioners, speech rehabilitators, psychologists
and ENT specialists are working together in further rehabilitation of the patients. |
