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The Role of Nursing in Patients with Obstructive Sleep Apnea

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In a population where people are not well versed with various ailment and disorders that the suffer suffering can persist for a very long time. Nursing or simple the care for the sick can be very instrumental in helping in the identification of such ailment and providing specialized care to individuals suffering from such ailments. This essay keenly discuses the roles that nursing can play in the management of patient suffering from obstructive sleep disorder. Such roles include identification of the condition diagnosis, management of treatment, advising and providing support as well as education to the patients. In discussing this roles the essay also looks at the nurse since it is the nurse who is at the heart of the care given to the patients

Introduction

Obstructive sleep apnea which is also known as sleep apnea is a common disorder characterized stopping to breathe repeatedly during sleep.  Often the patient may stop breathing for about a minute or even linger and this may recur over a hundred times within a single night. The order is got its name from the word “apnea” which is a Greek word meaning “without breath.” The disorder could be a product either partial obstruction of the wind pipe which is known as obstructive hypopnnea or hupopnea charecterised by slow and shallow breathing, or it can be caused by total obstruction of the wind pipe- obstructive apnea. In both cases the patient can be awaken from sleep by their condition. The disorder is of three types namely, central, obstructive and mixed. Of the three, obstructive sleep apnea is the most common. Obstructive sleep apnea affects over 18 million individuals in the U.S. In many instances the patients continue to harbor the condition undiagnosed. This paper will examine and discus the role played by nursing in the care of patients suffering from obstructive sleep.

Identification of the condition and diagnosis

Nurses can be very instrumental in recognizing patients with obstructive sleep. Sleep apnea remains considerably undiagnosed within the human population and more so in the hospital wards. Creation of awareness in the nurse population is a very critical issue. Nurse awareness of constructive sleep in the day to day monitoring of patients can facilitate purposive observations to identify these who at risk of suffering from such a condition or those who already have the disorder and facilitate appropriate referral (Shafazand, 2009).

Tools for identifying the condition and the disorders symptoms

The nurses at hospital can be equipped with various tools which can enable them diagnose sleeping disorders in wards. On of such tools can be the Berlin Questionnaire which has been used previously to diagnose condition such as obesity and hyperbatons.  The five item pediatric sleep screening tool BEARS can also be used to diagnose patients for sleep apnea. BEARS stand for Bedtime Issues, Excessive Daytime sleepiness, Night Awakenings, Regulation and Duration of Sleep and Snoring. Here BEARS for are used to record the patients behavior over a period of time to detect any abnormality associated with sleep disorders.  When the nurses know what to look out for they can help in diagnosing all cases of sleep apnea accurately and thus facilitate in the treatment of the condition (Shafazand, 2009). Obesity and hypertension are sure signs to suspects the condition.  Large neck circumference is characteristic sign of the condition that the nurses can look for. In most case a subsequent examination of the upper cavity of the airway will reveal the existence of enlarged tonsils that lead to obstruction.  Macroglossia, nasal obstruction and an elongated uvula will also be present. Further attention should also b paid to the mandible size.

The Epworth sleepiness scale can also be used to diagnose the condition. This is a scale developed to facilitate examination through a self administered questionnaire. The questionnaire is used to determine the possibility of a person falling asleep in 8 deferent common circumstances. Each question has a gage ranging from 0-3. 0 is the lowest figure representing the lowest possibility of falling asleep in any circumstances while 3 is the highest figure representing the highest possibility of falling asleep. The score facilitates the distinguishing of usual subjects such as snoring from sleep apnea and other sleep disorders (Malcolm, 2005).     

The nurse can also ask questions about the sleep pattern and habits. The nurse should be interested in singling out habits such as waking habits, snoring, and night wakening. In most cases patients do not volunteer to give information thus necessitating thorough questioning. In addition to the above responses, other Reponses that may suggest apnea include daytime sleepiness or tiredness, dry mouth in the morning, morning headaches, impotence and intellectual impairment. Through questioning, observation could help detect the condition early or construct the patients ailing history thus facilitate in the creation of proper intervention

Treatment

In the treatment and management of apnea, the nurses can be instrumental in educating the patient about their condition and the importance of seeking medication. Through such education the nursing can lead to discoveries of new cases of apnea within the population (Malcolm, 2005). Education creates awareness in the public and thus, this explains why with education provided by the nurses results in increased numbers of reported cases of the condition. Education also serves to assure the patients that their condition can be managed and encourage them to keep to the medication routine.

Patient care

Nursing is also very important in the care of the patients.  The disorder is mostly managed by primary health care. Nurse’s understanding of the condition is very useful in helping patients to manage their apnea condition while in hospital. A good example is the use of the CPAP device. Many patients may be pessimistic about carrying the device to the hospital due to the fear of interfering with other patients. From the nurses’ experience, such devise can be properly installed and used without disturbing the patients (Alexander, 2006). However, when it comes to the using the device at home the nurse will teach the patient and help them understand how to use it. Such would include demonstrations and explanation of how the device works and how to operate it. The nurse must also demonstrate on how to present possible problems or complications in the use of the device (Miller, 2009).

Advise on life style change

Treatment and management of sleep apnea may also require a change in the lifestyles of patients. This can also be included in to the nursing program of the patients. Change in lifestyle involving giving up of some personal habits such as reduction of alcohol consumption and desisting from smoking. Patient is strongly advised to avoid using sedatives and weigh loss is also recommended. Making drastic change to a patients lifestyle is not always easy mores so when such a patient is under stress. Trying to achieve numerous goals at the same time can be counter productive. For instance weight gain is normally common when quitting smoking and this can make the situation very difficult for the patient. Though behavior change or lifestyle change can be very useful in helping in the management of the condition, the use of the continuous positive airway pressure (CPAP) overnight is the best treatment that can be given to the patient. The devise deliver air through a nasal cannuka which supports the breathing and inhibits the collapse that usual occurs prior to the apnea. The repeated use of the devise ensures that the obstructive apnea doe not occur and normal sleep patterns take place. This leads in the reduction of symptoms associated with the disorder, thus the reduction in sleepiness during the day, improved cognitive performance among others (Malcolm, 2005).

Conclusion

Nursing certainly plays a crucial role in the management of obstructive sleep apnea. Nurses can help by asking useful questions to patients that facilitated the diagnosis of the condition. In hospital condition or environment the nursing can be very useful in observing the sleeping patterns of patient to understand the extent of their condition. The nurses advice the patient on the change of their life styles and facilitates them in achieving it. Also the role of explanation and demonstration of how to use various facilities such as the CPAP device used in the treatment of the disorder is conducted by nurses. Finally, nursing helps in the identification and managing of the symptoms of this disorder. With nurses who are aware of the condition the cases of this disorder that stay undiagnosed reduce considerably.

 

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