The polysomnogram confirms S.R.'s diagnosis of OSA. At his 6-week follow-up visit, he reports he has lost 10 pounds, but there has been little improvement in his symptoms. He states that he fell asleep while driving to work and wrecked his car. He wants t
What are the treatment options for OSA? Describe each.
Appliances: Mild OSA can be treated with use of dental appliances that move and hold the mandible
in a forward position.
Continuous positive airway pressure (CPAP): A machine generates a continuous flow of air to the upper
airways throughout the respiratory cycle. The airflow is delivered with sufficient pressure to
prevent the upper airway from collapsing during inspiration. This method can be used through a
nasal pillow, nasal mask, or full-face mask.
CPAP with O2: This is the same as CPAP but with added O2 through the machine or by nasal cannula.
This method can be used with a nasal pillow, nasal mask, or full-face mask.
Bilevel positive airway pressure (BiPAP): BiPAP differs from CPAP in that it delivers two different levels
of airflow, with a higher pressure given during inhalation and a lower pressure given during exhalation.
Surgical Options
Tonsillectomy, with or without adenoidectomy, or a uvulopalatopharyngoplasty: The removal of the
uvula, part of the soft palate, and mucosa of the pharynx might be done to enlarge the throat.
Reports of success vary widely, from 40% to 80%.
Mandibular advancement surgery: This may be performed for a congenitally small mandible.
Tracheostomy: This surgical procedure creates an artificial opening into the trachea from the neck.
The patient places a cap over the opening during the day, allowing the patient to breathe and
speak normally. The patient connects himself or herself to humidified O2 at night, thereby
bypassing any upper airway obstruction. This treatment option is reserved for life-threatening
sleep apnea.
Bariatric surgery: This might be considered in the efforts to facilitate weight loss, therefore improving
symptoms of OSA.
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Which of the following colleagues would a nurse typically delegate to in the health care setting (select all that apply)?
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It is important to plot the school-age child's height and weight on a standardized growth chart because:
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Recognizing the risk for acquired immunodeficiency syndrome (AIDS) among older adults, nurses should provide health teaching aimed at:
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