Question

2. Molly Baker, a 22-year-old patient, presents to the clinic with the diagnosis of allergic rhinitis. She states that she develops paroxysmal sneezing, clear nasal drainage and congestion, watery, red eyes, and nasal itching from the late spring until the first frost in the fall. She states that she has a dry cough and voice hoarseness. She complains of feeling extremely tired, unable to sleep at night, and having difficulty concentrating on her collegiate course work. (Learning Objective 5)

1. What further assessment should the nurse provide?

   The patient states that she sees an increase in her symptoms when the mold count is high. She also states that she sneezes when she is around her cat and the cat sleeps with her at night. The patient agrees to pharmacotherapy and avoidance therapy. The physician orders for her to take over-the-counter cetirizine (Zyrtec) from late spring until the first frost in fall.

2. What nursing interventions should be provided?

Answer 1

ANSWERS:-

a) What further assessment should the nurse provide?

* The nurse should perform an allergic test with mold and animal dander . The positive reactions towards these shows her allergies.

* IgE and esinophil count also increase in allergic rhinitis.

*Allergic rhinitis is inflammation of nasal mucosa associated with a group of symptoms.

* These symptoms occurs when a person breathe in allergens such as pollens, mold, animal dander or dust.

* Molly Baker's history reveals that the symptoms start from late spring until the first frost in the fall, and increases when mold count is high, and sneezes when she is around her cat.

* It clearly shows she is allergic to multiple allergens.

b) What nursing interventions should be provided?

* Instruct and assist to modify the environment to prevent occurrence and to reduce the severity of symptoms.

* Stay indoor during seasons when mold count is high.

* Keep home less mold friendly by controlling moisture in the air.

* Wear a dust mask while going out.

* Keep away the pet cat, don't sleep with the cat.

* Advice to keep compliance with medications and avoidance therapy.

* Avoidance therapy is done to remove the allergens that act as precipitating factors. Examples include use of air conditioners, air cleaners, humidifiers, and dehumidifiers and smoke free environment.

* Instruct the patient to avoid alcohol, driving etc after taking medication (cetrizine ) because it cause drowsiness.