Medical Surgical Obstructive Sleep Apnea (OSA) #5
While performing the medical interview on a preoperative 51-year-old male with a BMI of 31 and thick neck circumference, which question by the nurse would be most appropriate?
- “Do you drink alcohol?”
This answer is not correct because although it is an important question, it is not the most appropriate for the client undergoing surgery with a BMI of 31 and thick neck circumference. Those are risk factors for OSA and that needs to be known before undergoing sedation for a surgical procedure.
- “Do you have obstructive sleep apnea?”
This answer is correct because OSA puts the client at higher risk for problems with perioperative anesthesia or pain medication. These clients require special management and close monitoring to reduce the risk of a blocked airway. The nurse’s observation of this client’s physical characteristics suggests he could have OSA.
- “Do you have kidney problems?”
This answer is not correct because although that is an important question to ask, it is not the most appropriate due to the client’s physical characteristics. Renal disease can increase the incidence of surgical complications.
- “Do you have diabetes?”
This answer is not correct because while knowing if the client is diabetic is important information, it is most important knowing if the client may be at risk for airway complications. Clients with endocrine disease, specifically diabetes may require specific changes to be made in the perioperative period.
A client who is middle-aged, obese, and has a large neck circumference is at an increased risk for obstructive sleep apnea (OSA). A person with OSA will need to notify the surgeon about the condition due to the potential risks of being sedated with this condition.
If a client is having surgery, it is important to know that the client has obstructive sleep apnea. OSA can make anesthesia much riskier for clients undergoing surgery because breathing is slowed down and the client becomes more sensitive to the effects of anesthesia. OSA clients have a harder time regaining consciousness and taking that first breath after surgery.
Test Taking Tip
When neck circumference is mentioned, think obstructive sleep apnea.