A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for development of obstructive sleep apnea?

A 42-year-old man with gastroesophageal reflux disease

A 55-year-old woman who is 50 lb (23 kg) overweight

A 20-year-old woman who is 8 months pregnant

A 73-year-old man with type 2 diabetes mellitus

Answer and Explanation

The Correct Answer is B

Choice A Reason:

A 42-year-old man with gastroesophageal reflux disease (GERD) is not at the highest risk for obstructive sleep apnea (OSA). While GERD can be associated with OSA, it is not a primary risk factor. The main risk factors for OSA include obesity, age, and anatomical features that can obstruct the airway. Therefore, this individual is not at the greatest risk compared to others.

Choice B Reason:

A 55-year-old woman who is 50 lb (23 kg) overweight is at significant risk for developing OSA. Obesity is one of the most critical risk factors for OSA because excess weight can lead to fat deposits around the upper airway, which can obstruct breathing during sleep. Additionally, being overweight increases the likelihood of other conditions that can exacerbate OSA, such as hypertension and metabolic syndrome.

Choice C Reason:

A 20-year-old woman who is 8 months pregnant may experience temporary sleep disturbances, including snoring and mild sleep apnea, due to hormonal changes and increased abdominal pressure. However, pregnancy-related sleep apnea is usually transient and resolves after childbirth. Therefore, while she may have an increased risk during pregnancy, it is not as significant as the risk posed by obesity.

Choice D Reason:

A 73-year-old man with type 2 diabetes mellitus has an increased risk of OSA, as diabetes is associated with obesity and metabolic syndrome, which are risk factors for OSA. However, the presence of diabetes alone does not pose as high a risk as obesity. Therefore, while this individual is at risk, it is not as high as the risk associated with being significantly overweight.

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Correct Answer is ["A","B","C"]

Explanation

Choice A: Increased Respiratory Rate

Fluid overload, also known as hypervolemia, can lead to an increased respiratory rate. This occurs because the excess fluid in the body can accumulate in the lungs, leading to pulmonary congestion and edema. As a result, the body attempts to compensate by increasing the respiratory rate to improve oxygenation and remove excess carbon dioxide. Normal respiratory rate for adults is typically between 12-20 breaths per minute. An increased respiratory rate above this range can indicate fluid overload.

Choice B: Increased Heart Rate

An increased heart rate, or tachycardia, is another common finding in clients with fluid overload. The heart has to work harder to pump the excess fluid throughout the body, leading to an increased heart rate. This is a compensatory mechanism to maintain adequate cardiac output and tissue perfusion. Normal resting heart rate for adults is between 60-100 beats per minute. A heart rate above this range can be indicative of fluid overload.

Choice C: Increased Blood Pressure

Fluid overload can also result in increased blood pressure, or hypertension. The excess fluid in the bloodstream increases the volume of blood that the heart has to pump, leading to higher pressure within the arteries. This can strain the cardiovascular system and lead to complications if not managed properly. Normal blood pressure is typically around 120/80 mmHg. Blood pressure readings consistently above this range can suggest fluid overload.

Choice D: Increased Hematocrit

Increased hematocrit is not typically associated with fluid overload. Hematocrit is the proportion of red blood cells in the blood. In cases of fluid overload, the hematocrit level is usually decreased due to the dilutional effect of the excess fluid. Therefore, this choice is incorrect.

Choice E: Increased Temperature

Increased temperature is not a common finding in fluid overload. Fever or elevated body temperature is more commonly associated with infections or inflammatory conditions. Fluid overload does not typically cause an increase in body temperature. Therefore, this choice is incorrect.

A. Instruct the patient to withhold any medication for diuretic therapy. B. Prepare to administer fluids 2 hours before the procedure for patients with renal dysfunction. C. Advise the patient to take all anticoagulants. D. Administer steroids if the patient has an allergy to iodine-based contrast. E. Ensure that the patient is NPO for a minimum of 2 hours before the procedure.

Correct Answer is ["A","C","D","E"]

Explanation

Choice A: Instruct the patient to withhold any medication for diuretic therapy.

Reason: Diuretics can lead to dehydration and electrolyte imbalances, which can complicate the cardiac catheterization procedure. Withholding diuretics helps to maintain fluid balance and reduce the risk of complications during the procedure

Choice B: Prepare to administer fluids 2 hours before the procedure for patients with renal dysfunction.

Reason: Administering fluids before the procedure helps to prevent contrast-induced nephropathy, especially in patients with renal dysfunction. Hydration helps to flush out the contrast material used during the procedure, reducing the risk of kidney damage.

Choice C: Advise the patient to take all anticoagulants.

Reason: This choice is incorrect. Patients are usually advised to withhold anticoagulants before a cardiac catheterization to reduce the risk of bleeding complications. The decision to continue or withhold anticoagulants should be based on a careful assessment of the patient’s risk of thromboembolism versus the risk of bleeding.

Choice D: Administer steroids if the patient has an allergy to iodine-based contrast.

Reason: Administering steroids is a common premedication strategy for patients with a known allergy to iodine-based contrast media. Steroids help to reduce the risk of an allergic reaction during the procedure.

Choice E: Ensure that the patient is NPO for a minimum of 2 hours before the procedure.

Reason: Ensuring that the patient is NPO (nothing by mouth) helps to reduce the risk of aspiration during the procedure. Typically, patients are advised to be NPO for 6-8 hours before the procedure, but a minimum of 2 hours is essential.

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A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for development of obstructive sleep apnea?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (Select all that apply)

Correct Answer is ["A","B","C"]

Explanation

In addition to assessing peripheral pulses and auscultating the patient’s heart and lung sounds, which action will be implemented by the nurse before a cardiac catheterization? Select all that apply. One, some, or all responses may be correct.

Correct Answer is ["A","C","D","E"]

Explanation

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