Allergic Rhinitis

AKA Hay Fever

ETIOLOGY

Predisposing factors

Genetics

Age

Sex

Female Gender

Family History

Birth during the pollen season

Precipitating factors

Exposure to environmental allergen (pollen,dust,animal hair, molds spores)

Presence of allergens IgE

Exposure to smoking

Bacterial or viral infection

Food allergy

DISEASE PROCESS

Allergen Exposure *INGESTION OR INHALATION

Allergy Sensitization

Increase IgE

Mast Cells *degranulation

Inflammatory Mediators *histamine, Leukotrienes

 Can lead to*

*3 arrow*

Local inflammation *red itchy swollen eyes

*gitna* Trigeminal nerve *sneezing

Increase of mucous glands secretion *runnynose, nasal congestion

If treated *nursing management

If not treated

Prognosis: If left untreated, many complications may result, such as allergic asthma, chronic nasal
obstruction, chronic otitis media with hearing loss, anosmia (absence of the sense of smell), and, in
children, orofacial dental deformities. Early diagnosis and adequate treatment are essential to reduce
complications and relieve symptoms.

SIGNS AND SYMPTOMS

Red itchy swollen eyes

Sneezing

Runny nose

Nasal congestion

Allergic rhinitis can affect quality of life by also producing fatigue, loss of sleep, and poor concentration

Medical Management

The goal of therapy is to provide relief of symptoms. Therapy may include one or all of the following
interventions:
Avoidance therapy use of air conditioners, air cleaners, humidifiers, removal of dust catching
furnishings, carpets and window coverings, removal of pets from the home or bedroom use of pillow
and mattress covers that are impermeable to dust mites and a smoke free environment

Pharmacotherapy Antihistamines are the major class of medications prescribed for the symptomatic
relief of allergic rhinitis.

Adrenergic agents: vasoconstrictors of mucosal vessels are used topically nasal and ophthalmic

Mast cell stabilizers

Corticosteroids

Leukotriene Modifiers

And Immunotherapy all

Nursing Management

Improving breathing pattern

Promoting understanding of allergy and allergy control

Coping with a chronic disorder

Monitoring and managing potential complications

Promoting home and community based care

Identify the patient’s known allergens (eg, medications,foods, insects, environmental allergens).

• Describe the patient’s typical allergic reaction and its severity.

• Document the patient’s allergies (eg, medications, foods, insects, environmental allergens) in the
patient’s medical record.

• Post allergy alerts appropriately.

• Encourage the patient to wear a medical alert band and to carry information about allergies at all
times.

• Monitor the patient closely after administration of new medications and exposure to new foods,
contrast agents, latex, and other allergens.

• Investigate potential for allergic reactions with all new medications through consultation with the
pharmacist.

• Instruct the patient to question all medications and new foods.

• Identify early manifestations of allergic reactions.

• Administer emergency treatment for allergic reactions.

• Monitor the patient’s response and status for

12–14 hours after a severe allergic reaction.

• Instruct the patient and family about emergency home management of allergic reaction.

• Instruct the patient and family about avoidance measures to reduce risk of exposure to allergens

Diagnostic Test

Nasal smears, RAST (Radioallergosorbent test) peripheral blood counts, total serum IgE, epicutaneous
and intradermal testing, RAST, food elimination and challenge, and nasal provocation tests.

Nursing diagnosis

 Ineffective breathing pattern related to allergic reaction

 Deficient knowledge about allergy and the recommended modifications in lifestyle and self care
practices
 Ineffective individual coping with chronicity of condition and need for environmental
modifications