NURS 5461 GERIATRIC SPECIALTY TOPICS EXAM QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
In older adults, insomnia is often comorbid with other conditions
➢ Chronic illness ➢ Mood disturbance ➢ Less physical activity ➢ Physical disability
Screening Questions
Is the person satisfied with his or her sleep? • Does sleep or fatigue interfere with
daytime activities? • Does the bed partner or others complain of unusual behavior
during sleep, such as snoring, interrupted breathing, or leg movements?
Polysomnography if primary sleep disorder is suspected:
➢ Sleep apnea
➢ Narcolepsy
➢ Periodic limb movement disorder
➢ Violent or other unusual behaviors during sleep
➢ Other sleep symptoms that do not respond to treatment
Diagnostic criteria for sleep disorder
Difficulty falling sleep, difficulty staying asleep, waking too early, or sleep that is
nonrestorative or poor in quality 2. Adequate opportunity and circumstances for sleeping
3. Daytime impairment related to the sleep complaint, such as fatigue, poor attention,
mood disturbance, daytime sleepiness, or other complaints
Insomnia A/W Psych
, Depression is a common cause of sleep problems, Bereavement, anxiety, and stress
can also be associated with sleep difficulties
Medical problems can contribute to sleep difficulties:
➢ Pain from arthritis, other conditions ➢ Paresthesias ➢ Cough ➢ Dyspnea from
cardiac or pulmonary illness ➢ Gastroesophageal reflux
Central Sleep Apnea
cessation of breathing without associated respiratory effort ➢ Cheynes-Stokes pattern
of sleep apnea has a crescendo-decrescendo pattern
**Initial treatment should focus on management of heart failure, if present
OSA
Characterized by complete (apnea) or partial (hypopnea) upper airway obstruction
during sleep, with evidence of respiratory effort during the events • Excessive daytime
sleepiness is common • Patients may have morning headache, personality changes,
poor memory, confusion, and irritability • Bed partner may report loud snoring, cessation
of breathing, and choking sounds during sleep
OSA Risk Fcators
• High body mass index (BMI) and large neck circumference are important predictors,
Other reported predictors: ➢ Falling asleep at inappropriate times or napping ➢ Male
gender • Alcoholism is an important risk factor • Some evidence of an association with
dementia
Main treatment OSA
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
In older adults, insomnia is often comorbid with other conditions
➢ Chronic illness ➢ Mood disturbance ➢ Less physical activity ➢ Physical disability
Screening Questions
Is the person satisfied with his or her sleep? • Does sleep or fatigue interfere with
daytime activities? • Does the bed partner or others complain of unusual behavior
during sleep, such as snoring, interrupted breathing, or leg movements?
Polysomnography if primary sleep disorder is suspected:
➢ Sleep apnea
➢ Narcolepsy
➢ Periodic limb movement disorder
➢ Violent or other unusual behaviors during sleep
➢ Other sleep symptoms that do not respond to treatment
Diagnostic criteria for sleep disorder
Difficulty falling sleep, difficulty staying asleep, waking too early, or sleep that is
nonrestorative or poor in quality 2. Adequate opportunity and circumstances for sleeping
3. Daytime impairment related to the sleep complaint, such as fatigue, poor attention,
mood disturbance, daytime sleepiness, or other complaints
Insomnia A/W Psych
, Depression is a common cause of sleep problems, Bereavement, anxiety, and stress
can also be associated with sleep difficulties
Medical problems can contribute to sleep difficulties:
➢ Pain from arthritis, other conditions ➢ Paresthesias ➢ Cough ➢ Dyspnea from
cardiac or pulmonary illness ➢ Gastroesophageal reflux
Central Sleep Apnea
cessation of breathing without associated respiratory effort ➢ Cheynes-Stokes pattern
of sleep apnea has a crescendo-decrescendo pattern
**Initial treatment should focus on management of heart failure, if present
OSA
Characterized by complete (apnea) or partial (hypopnea) upper airway obstruction
during sleep, with evidence of respiratory effort during the events • Excessive daytime
sleepiness is common • Patients may have morning headache, personality changes,
poor memory, confusion, and irritability • Bed partner may report loud snoring, cessation
of breathing, and choking sounds during sleep
OSA Risk Fcators
• High body mass index (BMI) and large neck circumference are important predictors,
Other reported predictors: ➢ Falling asleep at inappropriate times or napping ➢ Male
gender • Alcoholism is an important risk factor • Some evidence of an association with
dementia
Main treatment OSA
