Unit 4 Chapter 26 Obstructive Sleep Apnea and Upper Airway Obstruction

Question 1

What is Airway Obstruction

Answer 1

Upper airway obstruction is the interruption of airflow through nose, mouth, pharynx, or larynx. When gas exchange is impaired, obstruction can be a life-threatening condition. Early recognition is essential to prevent complications, including respiratory arrest and death. Causes of upper airway obstruction include:

• Tongue edema (surgery, trauma, angioedema as an allergic response to a drug)
• Tongue occlusion (e.g., loss of gag reflex, loss of muscle tone, unconsciousness, coma)
• Laryngeal edema from any cause (e.g., smoke or toxin inhalation, local or generalized inflammation, allergic reactions, anaphylaxis)
• Peritonsillar and pharyngeal abscess * Head and neck cancer
• Thick secretions
• Stroke and cerebral edema
• Facial, tracheal, or laryngeal trauma or burns * Foreign-body aspiration

Question 2

At risk patients for Airway Obstruction

Answer 2

Those with decreased LOC, dehydrated,
risk of aspiration or unable to cough

Question 3

Nursing Interventions for Airway Obstruction

Answer 3

Assess for the cause of the obstruction. When the obstruction is caused by the tongue falling back or excessive secretions, slightly extend the patient’s head and neck and insert a nasal or an oral airway. Suction to remove obstructing secretions. If the obstruction is caused by a foreign body that cannot be removed by clearing the oral cavity manually, perform abdominal thrusts

NEVER BLIND SWAB

Question 4

When answering the call light for a client on bedrest, the nurse finds the client’s visitor unconscious on the floor with no discernable pulse and not breathing. The nurse estimates that at least 2 minutes have passed since the client’s light first came on. What is the nurse’s priority action?
A. Initiate CPR with chest compressions.
B. Perform an abdominal thrust maneuver.
C. Assess the visitor for the presence of a head injury. D. Ask the client what event led up to the visitor’s fall.

Answer 4

A. Initiate CPR with chest compressions.

Question 5

Unconscious pt, no pulse, what would you do?

Answer 5

Abdominal thrust maneuver is performed on an unconscious patient instead of chest compressions only when a known obstruction is present and the patient has a palpable pulse. If no obstruction has been observed in an unconscious person, chest compressions are started instead of abdominal thrusts because many more unconscious adults have cardiac problems than have airway obstruction.

Question 6

What is Obstructive Sleep Apnea?

Answer 6

Obstructive sleep apnea (OSA) is a type of breathing pattern ern disruption during sleep that lasts at least 10 seconds and occurs a minimum of five times in an hour

Question 7

Risk factors for Obstructive Sleep Apnea

Answer 7

Obesity and/or large neck circumference
Chronic nasal congestion, allergic rhinitis
Narrowed airways, asthma, enlarged tonsils
or adenoids
Recessed lower jaw
Family history, first degree relatives, non-
white, age 50-59, male

Question 8

CPAP

Answer 8

Noninvasive positive-pressure ventilation (NPPV) via continuous positive airway pressure (CPAP) to hold open the upper airways is the most commonly used form of nonsurgical management for OSA. CPAP delivers a set positive airway pressure continuously during each cycle of inhalation and exhalation with the use of a small electric compressor and some type of delivery device such as a nasal-oral facemask, nasal mask, or nasal pillows (with or without cushioned or gel prongs).

Question 9

proper positioning for pt’s OSA

Answer 9

Any type of delivery mask or pillow used requires a proper and relatively tight fit to form a seal over the nose and mouth or just over the nose for successful therapy.

Answer 10

For CPAP, the effect is to open collapsed alveoli. Patients who may benefit from this form of oxygen or air delivery include those with atelectasis after surgery, those with cardiac-induced pulmonary edema, and those with COPD.