A nurse is assisting with teaching a class about sleep disorders. The nurse should include that which of the following conditions can cause central sleep apnea (CSA)?

Choice A reason : Asthma is a chronic condition characterized by respiratory symptoms such as wheezing, shortness of breath, and coughing due to airway inflammation and constriction. While genetic and environmental factors contribute to the development of asthma, there is no direct correlation between advanced maternal age and an increased risk of asthma in offspring. Asthma's etiology is multifactorial and more closely related to family history, exposure to allergens, and respiratory infections during early childhood.

Choice B reason : Spina bifida is a neural tube defect that occurs when the spine and spinal cord don't form properly. It's associated with factors such as folic acid deficiency during early pregnancy, certain medications, diabetes, and obesity. Although advanced maternal age may slightly increase the risk of chromosomal abnormalities, it is not considered a significant risk factor for spina bifida. Adequate intake of folic acid before conception and during early pregnancy is the most effective prevention strategy.

Choice C reason : Down syndrome is a genetic disorder caused by the presence of an extra copy of chromosome 21 (trisomy 21). The risk of conceiving a child with Down syndrome increases with maternal age, particularly after age 35. This is due to the higher likelihood of nondisjunction events during cell division in older eggs, leading to an abnormal number of chromosomes. Advanced maternal age is a well-established risk factor for Down syndrome, and prenatal screening is recommended to assess the risk.

Choice D reason : Facial malformations, such as cleft lip or palate, are congenital anomalies that can affect the appearance and function of a child's face. These conditions are influenced by genetic and environmental factors, including certain medications, nutritional deficiencies, and exposure to harmful substances during pregnancy. While advanced maternal age may contribute to an increased risk of chromosomal abnormalities, it is not specifically linked to an increased risk of isolated facial malformations.

Choice A reason : Applying lotion between the toes is not recommended for individuals with diabetic neuropathy. Moisture can accumulate in these areas, creating an environment conducive to fungal infections. Instead, lotion should be applied to the tops and bottoms of the feet to keep the skin moisturized and prevent cracking, but the areas between the toes should be kept dry⁵.

Choice B reason : Wearing open-toed shoes is generally not advised for patients with diabetic neuropathy. Open-toed shoes can expose the feet to injuries, which can go unnoticed due to the loss of sensation associated with neuropathy. It's important for individuals with diabetic neuropathy to wear well-fitting, closed-toed shoes that protect the feet from external injuries⁵.

Choice C reason : Washing feet in hot water is unsafe for those with diabetic neuropathy because they may not be able to accurately gauge the temperature due to reduced sensation, leading to burns. The water temperature should be warm, and individuals should always test it with their hands or a thermometer before immersing their feet⁵.

Choice D reason : Walking barefoot is risky for individuals with diabetic neuropathy because they may not feel cuts, scrapes, or other injuries due to decreased sensation in their feet. These injuries can lead to infections and ulcers if not treated promptly. Therefore, it is crucial to avoid walking barefoot and to always wear protective footwear, even indoors⁵.