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NUR 210-Exam 1 > Obstructive Sleep Apnea > Flashcards

Obstructive Sleep Apnea Flashcards

1
Q

What is obstructive sleep apnea?

A

Cessation of breathing (apnea) during sleep usually caused by repetitive upper airway obstruction

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2
Q

Larger neck circumference, increased peripharyngeal fat, and upper airway is compressed all fall under which risk factor?

A

Obesity

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3
Q

Being male, post-menopausal status, advanced age, tonsillar hypertrophy, posterior positioning of the jaw and variation in craniofacial structures are all what?

A

Other risk factors

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4
Q

How many apneic events are normal?

A

Up to 5 in an hour, w/ no D-sat

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5
Q

What constitutes severe obstructive sleep apnea?

A

Over 30 events in an hour

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6
Q

What nervous system is triggered that causes respiration’s, heart rate and blood pressure to increase during obstructive sleep apnea?

A

Sympathetic

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7
Q

What do OSA pt’s have a higher incidence of?

A

HTN, MI, stroke and pulmonary HTN

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8
Q

What are the 3 S’s to the clinical manifestations of OSA?

A

Snoring, sleepiness and significant other reports of sleep apnea events

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9
Q

Clinical manifestations of OSA?

A

Insomnia, nighttime/early morning awakenings w/ an inability to return to sleep and morning HA, chronic fatigue, daytime sleepiness, frequent MVA

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10
Q

Describe the apneic events of a pt w/ OSA?

A

Frequent/loud snoring w/ breathing cessation for 10sec for greater than 5epsisodes per hour to several hundred per night followed by awakening abruptly w/ a loud snort as blood O2 levels drop

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11
Q

What is the definitive study done to diagnose OSA?

A

Polysomnography (sleep study)- overnight test that keeps track of # of apneic events in an hour

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12
Q

What does a polysomnography measure?

A

EEG, electrooculogram, ECG, respirations, cardiac dysrhythmia, leg movements and pulse ox

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13
Q

What are some important medical/nursing management that needs to be done in a pt w/ OSA?

A

Weight loss, avoidance of alcohol, position therapy (not on back), oral appliances, CPAP/BiPAP (if severe), can add supplemental O2 via NC

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14
Q

What is CPAP?

A

Continuous positive airway pressure: pushes air in continuously

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15
Q

What is BiPAP?

A

Bilevel positive airway pressure: Has IPAP (Inspiratory positive airway pressure) and EPAP (Expiratory positive airway pressure)

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16
Q

What should always be used w/ a CPAP?

A

Distilled water and a humidifier (to reduce airway dryness)

17
Q

What is the surgery termed Uvulopalatopharyngoplasty?

A

Removal of pharyngeal soft tissue and removal of a portion of soft palate and uvula

18
Q

What is the surgery termed maxilomandibular surgery?

A

Advance the mandible and maxilla forward

19
Q

What is a curative surgical management for OSA?

A

Tracheostomy

20
Q

Tonsillectomy, adenoidectomy and nasal septoplasty are what?

A

Types of surgical

21
Q

What medication is a stimulant that decreases daytime sleepiness?

A

Modafinal (Provigil)

22
Q

What medication is taken @ bedtime; increases respiratory drive and improves upper airway muscle tone?

A

Protriptyline (Tripityl)

23
Q

Disturbed sleep pattern, anxiety, ineffective breathing pattern, impaired gas exchange, deficient knowledge, activity intolerance, risk for injury and fatigue are all what?

A

Nursing diagnosis

24
Q

What are some important nursing actions?

A

Teaching about obesity and sleep apnea, avoidance of alcohol/sedatives, how to use CPAP and measures to reduce airway dryness

25
Q

What type of sleep apnea occurs when there is a blocked airway by the soft palate, tongue and/or uvula?

A

Obstructive

26
Q

What type of sleep apnea occurs when the muscles of the chest and diaphragm fail temporarily?

A

Central

27
Q

How does a BiPAP differ from a CPAP?

A

A BiPAP produces less pressure during exhalation and more during inhalation causing less resistance to exhalation

28
Q

What are the 3 modes of ventilation for a BiPAP?

A

1: spontaneous breathing (S). 2: Timed mode (T) (pressure supported breaths are delivered @ a predetermined rate) 3: Spontaneous/Timed (S/T) switches to timed mode if spontaneous breathing fails below a preset rate

NUR 210-Exam 1 (9 decks)

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