unit 15 wound care Microsoft Word 文档.doc

Unit 15 wound careBreast CancerBreast cancer is the most common type of cancer among women. Breast cancer affects one in eight women during their lives. Men can have breast cancer too, but the number of cases is small. Breast cancer is the leading cause of death from all causes in women 40-44 years of age and is frequent in women of all ages over 30. No one knows why some women get breast cancer, but there are a number of risk factors. The women whose family members with breast or ovarian cancer are more likely to develop the disease. Risk is increased when when breast cancer has occurred before menopause, was bilateral, or was present in 2 or more first-degree relatives. Early menarche and late natural menopause are associated with a slight increase in risk of developing breast cancers. Other risks include being overweight, using hormone replacement therapy, taking birth control pills, drinking alcohol, not having children or having your first child after age 35 or having dense breasts.The earlier breast cancer is found and diagnosed, the better the chances of beating it. Women 20-40 years of age should have a breast examination as part of routine medical care every 2-3 years . If women are over 40 or at a high risk for the disease,they should have an annual radiography with molybdenum target tube and physical exam by a doctor.They may perform monthly breast self-exams to check for any change in their breasts. It is important to remember that changes can occur because of aging, your menstrual cycle,pregnancy, menopause, or taking birth control pills or other hormones. It is normal for breasts to feel a little lumpy and uneven. Also, it is common for the breasts to be swollen and tender right before or during their menstrual period. Breast self-exams cannot replace regular screening mammograms and clinical breast exams. Studies have not shown that breast self-exams alone reduce the number of deaths from breast cancer.The patient with breast cancer usually presents with a lump in the breast. The diagnosis of breast cancer is confirmed by biopsy. The presenting complaint in about 70% of patients with breast cancer is a lump (usually painless ) in the breast. About 90% of breast masses are discovered by the patient herself.Less frequent symptoms are breast pain,nipple discharge, erosion,retraction,enlargement, or itching of the nipple; and redness, generalized hardness, enlargement ,or shrinking of the breast.Inspection of the breast is the first step in physical examination and should be carried out with the patient sitting,arms at sides and then overhead.Palpation of the breast for masses or other changes should be performed with the patient both seated and supine with the arm abducted. Breast cancer usually consists of anon-tender, firm or hard lump with poorly delineated margins. Slight skin or nipple retraction is an important sign. Women with breast cancer have many treatment options. These include surgery, radiation therapy, chemotherapy, hormone therapy,and biological therapy. Treatment by segmental mastectomy plus axillary dissection and radiation therapy or by total mastectomy plus axillary dissection (modified radical mastectomy) is the best initial treatment for most patients with potentially curable carcinoma of the breast.Full discussion with the patient regarding the rationality for mastectomy and the manner of coping with the cosmetic and psychological effects of the operation is essential.Breast reconstruction should be discussed with the patient if this is a realistic possibility. Time spent preoperatively in educating the patient and her family is well spent.Post-operative care for the patient with mastectomy includes:(1) wound care and observation for bleeding.(2) promoting comfort by placing the patient in semi-Fowlers position and elevating the operated arm.(3)providing the patient with a protein-rich diet.(4) giving the patient some advice on activity and exercises, such as climbing the wall or arm swinging.(5) observing and recording any change of the patients physiologic and psychological conditions. New words ovarian uvrin adj. 卵巢的；子房的menopause menup:z n. 更年期；活动终止期bilateral balt()r()l adj. 双边的；有两边的menarche menk n. 初潮（少女的第一次月经来潮）hormone h:mun n. 激素，荷尔蒙radiography ,reidirfi n. 放射线照相术；X光线照相术molybdenum mlbdnm n. 化学 钼（金属元素，符号Mo，原子序号42）menstrual menstrul adj. 月经的；每月的；一月一次的pregnancy prennsi n. 怀孕；丰富，多产；意义深长lumpy lmpi adj. 粗笨的；波浪起伏的；多块状物的uneven ,ni:vn adj. 不均匀的；不平坦的；奇数的swollen swuln adj. 肿胀的，浮肿的；浮夸的；激动兴奋的lump lmp n. 块，块状；肿块；瘤；很多；笨人vt. 混在一起；使成块状；忍耐；笨重地移动biopsy bai,psi n. 活组织检查；活组织切片检查；切片检查法mass ms n. 块，团；群众，民众；大量，众多adj. 群众的，民众的；大规模的，集中的nipple nipl n. 乳头，奶头；奶嘴erosion irun n. 侵蚀，腐蚀retraction ritrkn n. 撤回，撤销；收回enlargement inl:dmnt n. 放大；放大的照片；增补物itch it n. 痒；渴望；vi. 发痒；渴望shrink rik vi. 收缩；畏缩vt. 使缩小，使收缩margin m:din n. 边缘；利润，余裕；页边的空白vt. 加边于；加旁注于segmental segmental sementl dj. 部分的axillary kslr n. 鸟 腋羽adj. 植 腋生的；腋窝的；叶腋的dissection disekn n. 解剖，切开；解剖体；详细查究cosmetic kzmetik adj. 美容的；化妆用的n. 化妆品；装饰品Phrases and Expressionsassociate somebodysomething with somebodysomething 联系cope with 处理，对付EXERCISESRead the passage aloud until you can say it from memory.Post-operative care for the patient with mastectomy includes:(1) wound care and observation for bleeding.(2) promoting comfort by placing the patient in semi-Fowlers position and elevating the operated arm.(3)providing the patient with a protein-rich diet.(4) giving the patient some advice on activity and exercises, such as climbing the wall or arm swinging.(5) observing and recording any change of the patients physiologic and psychological conditions. Vocabulary ExercisesComplete the short dialogues by using the words from the passage.consist occur discuss replace carry initial replace likely perform present 1. Its not a good idea to miss meals and_them with snacks2. Its more than _that the thieves dont know how much it is worth.3. On his birthday, his friend _him with a new book.4.Make exercises a part of your daily_5.This operation has never been _in this country.6.My _reaction was to decline the offer.7.Have you_the the problem with anyone?8.A lot of tests have been _out on the old man.9.When exactly did the incident_10.Their diet_largely of vegetablesTranslating:Translate the following into Chinese1. Breast cancer is the most common type of cancer among women.2. No one knows why some women get breast cancer, but there are a number of risk factors.3. Breast cancer usually consists of anon-tender, firm or hard lump with poorly delineated margins4. The patient with breast cancer usually presents with a lump in the breast.5. Slight skin or nipple retraction is an important signTranslate the following into English.1. high risk 高风险2. breast cancer乳腺癌3. the number of 数量4. post-operative care术后护理5. protein-rich diet.高蛋白饮食参考译文乳腺癌乳腺癌是女性癌症中最常见的一种。每八名妇女就有一名患有此病。男性也患乳腺癌，不过数量很少。4044岁之间因各种原因死亡的妇女中乳腺癌居首位，且常见于30岁以上各种年龄组。没有人知道为什么有的妇女会患乳腺癌，但是有许多危险因素。家庭中有人患乳腺癌或卵巢癌的妇女更有可能患有此病。若乳腺癌发生于绝经期前、双侧性或已有两个或两个以上直系亲属患病，则危险性增加。初潮较早、自然绝经较晚者发生乳腺癌的危险性略有增加。其他危险因素包括超重、使用荷尔蒙代替治疗、吃避孕药、喝烈性酒、没生育或35岁后才生小孩或胸部肥大。乳腺癌被发现和诊断得越早，就越有可能治愈它。作为常规医疗保健的组成部分，2040岁的妇女应该每23年做一次乳房检查。如果妇女年龄在40岁以上或患病的危险高，应该每年进行乳腺钼靶X线摄片检查或由医生进行体检。他们可以每月通过乳房自检来发现乳房的任何变化。重要的是要记住由于衰老、经期、妊娠、绝经或服用避孕药及其他激素药乳房可能出现的变化。觉得土方有点凹凸不平或不整齐是正常的。在月经前或在其期间常会有乳房胀痛或疼痛。乳房自检不可代替常规乳房筛查和临床检查。没有研究表明单独乳房自检减少乳房癌死亡人数。乳房癌患者通常表现为乳房内肿块，经穿刺活检进一步证实为乳腺癌。约70%乳腺癌病人的主诉是乳房内肿块（常为无痛性）。90%左右的乳房肿块是病人自己发现的。不太常见的症状有乳房疼痛、乳头分泌物、乳头糜烂、凹陷、增大或发痒以及乳房发红、全部变硬、增大或皱缩。乳房的视诊是体检的第一步，应置病人于坐位进行，先将两臂放在体侧，然后放在头顶。