Week 6: Rhinitis

Question 1

What is It?

Answer 1

inflammation and irritation of mucous membranes lining the nose

• most common problem with the nose and sinuses
• classified as allergic, non-allergic, and acute or chronic
• also affect eyes, throat, and ears

Question 2

What does the presence of an allergen cause?

Answer 2

causes histamine release and other mediators from WBCs in the nasal mucosa.
>the mediators bind to blood vessel receptors causing capillary leakage, which leads to local edema and swelling

Question 3

How does Allergic Rhinitis occur?

Answer 3

in response to exposure to allergens found in the environment, medications, foods, or occupational irritants

• the lining of the nasal mucosa becomes inflamed, congested and edematous
• mechanical obstructions within the nose or sinuses, such as polyps, nasal septal deviation, and hypertrophy of the nasal turbinate or sinus tumors, may also result in the development of rhinitis

Question 4

Common environmental allergens

Answer 4

mold, dust mites, cockroach droppings, weeds, trees, and animal dander

Question 5

Foods that may induce allergic rhinitis

Answer 5

peanuts, cows milk, nuts, eggs, and wheat

Question 6

Allergic Rhinitis

Answer 6

categorized as perennial (occurring throughout the year) or seasonal

Question 7

Non-allergic Rhinitis

Answer 7

• does not involve immune system
• example: common cold
• caused by a variety of viruses and is usually self-limiting unless bacteria infection occurs simultaneously

Question 8

Clinical Manifestations

Answer 8

• nasal itching, sneezing, nasal congestion, and rhinorrhea (runny nose), itchy, watery-eyes, sore dry throat
• headache, fatigue, sleep disturbances, and cognitive impairment

Question 9

Diagnosis

Answer 9

• based on history and symptoms
• dependent on the cause
• obtaining a history of onset of symptoms that focuses on the pattern, seasonal aspects, environmental exposures to allergens in the home or work, and precipitating factors serves as basis of determining treatment

Question 10

Diagnostic Procedures

Answer 10

• in allergic rhinitis; allergy testing may be indicated, followed by a desensitizing regimen
• referral to an ears, nose, and throat specialist for assessment of nasal polyps, nasal septum deviation, and hypertrophy of the nasal turbinate or sinus tumors may be indicated

Question 11

Medications

Answer 11

• Antihistamines
• Intranasal corticosteroids (most effective in allergic rhinitis)
• Decongestants
• antipyretic for fever
• antibiotics if bacterial infection

Question 12

Complications

Answer 12

sedation, performance impairment, and anticholinergic effects such as dry mouth, constipation, and increased heart rate are common side effects of first generation anti-histamines
-can lead to obstructive sleep apnea (OSA)

Question 13

Client Education

Answer 13

• appropriate use of medications
• avoidance of known allergens or triggers
• hand hygiene; preventing the spread of infection

Question 14

Medication: First-generation antihistamine

Answer 14

-diphenhydramine (denadryl allergy)

Question 15

Medication: Second Generation Antihistamine

Answer 15

-loratadine (Alavert, Claritin)

Question 16

Medication: Decongestant

Answer 16

-guaifenesin (robitussin, mucinex)

Question 17

Medication: Corticosteroids nasal spray

Answer 17

flucticasone

Question 18

Medication: Antihistamine nasal spray

Answer 18

azelastine (Astelin)

Question 19

Therapeutic Procedures

Answer 19

symptom relief