To validate the suspicion that a married male client has sleep apnea the nurse first:
A. Asks the client if he experiences apnea in the middle of the night.
B. Questions the spouse if she is awakened by her husband’s snoring.
C. Place the client on a continuous positive airway pressure (CPAP) device.
D. Schedules the client for a sleep test.
Correct Answer: D. Schedules the client for a sleep test.
Although this is a diagnostic tool, the first thing the nurse would do is question the spouse. This may lead to determining whether more tests are needed. Obstructive sleep apnea syndrome is a condition in which there is a dynamic collapse of upper airway tissues during sleep. This may result in recurrent respiratory-related events and both short-term symptomatic consequences and long-term physiologic consequences.
Option A: Inquiring regarding sleep hygiene and screening for other sleep-related diagnoses is also important. One of the key points is to determine whether the patient is experiencing sleepiness associated with OSA, from fatigue, which indicates alternative medical diagnoses.
Option B: A complete history for a patient presenting with signs or symptoms of OSA must be obtained, including symptoms of daytime sleepiness, associated sleep symptoms, snoring, coughing, or choking during sleep, morning headaches, chest pain, dyspnea, or neuropsychiatric changes.
Option C: For adults, the use of continuous positive airway pressure (CPAP) is the most effective treatment, and diligent adherence to nightly CPAP use can result in near-complete resolution of symptoms. For patients unable or unwilling to use CPAP or those who will be unable to access electricity reliably, custom-fitted and titrated oral appliances can be used to bring the lower jaw forward and relieve airway obstruction.
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