The nurse is most concerned about which assessment finding in an older client with sleep apnea?
1. The client's body mass index is 48.7.
2. The client takes a sleeping medication at night.
3. The client has a family history of sudden death.
4. The client has added pillows for sleep at night.
3. The client has a family history of sudden death.
Explanation: 1. Obesity is associated with sleep apnea. Obesity does make sleep apnea much worse.
2. Persons with sleep apnea seldom achieve deep sleep because of frequent brief awakenings to end the apneic episodes. Sedative-hypnotics are often prescribed for sleep and are contraindicated in the client with sleep apnea due to inability to arouse when needed during apneic episodes.
3. The person with sleep apnea is subject to episodes of hypoxemia, which increases the risk for sudden death and stroke. A family history of sudden death often indicates familial cardiovascular disease leading to death. This indicates the client is at high risk from complications of unmanaged sleep apnea.
4. In sleep apnea, the muscles in the throat, soft palate, and tongue relax during the night and cause airway obstruction. As the condition worsens, the client will sit more upright during sleep to deal with apneic episodes and feelings of choking in the night.
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