Allergic Rhinitis

Allergic rhinitis a form of allergic reaction in the respiratory system which is characterized by seasonal occurrences. Children and adolescents are mostly affected by this. Over all this is the most common allergic reaction that happens on all age groups and it has a family origin also.

Etiology:

1. Pollens from trees, grass and weed which usually increases during spring, summer and fall respectively.
2. Harsh environmental factors like pollution, smoke and strong smells.
3. Other triggering factors can cause year-round symptoms that do not appear to be associated with specific triggers. Dust mite and animal exposure are called perennial allergens. There is a tendency also for chronic symptoms to appear.

Pathophysiology:
The immunoglobulin (Ig) E increases whenever an inhaled allergen stays on the mucosal surface. It combines with nasal mucosa. The nasal mucosa  then becomes edematous and leukocytes infiltrated it. There is tissue edema since capillary permeability increases.

Signs and Symptoms:

1. Itching, burning nasal mucosa
2. Copious mucous secretions causing runny nose
3. Red, burning, teary eyes
4. Sneezing
5. Pale, boggy nasal mucosa

Diagnostic evaluation:

1. Nasal smears indicates eosinophil in nasal secretions.
2. Peripheral blood count – lymphocytes increase above 1,200 mL
3. Elevated serum IgE
4. Skin test positive among various allergens
5. Radioallergosorbent test – specific test for IgE, antibodies are present when they combine with the radiolabeled allergens

Medical management:

1. Prescription of use of anti-histamines. There non-drowsing anti-histamines that are available in the market.
2. Immunotherapy. This is advised for clients with specific inhalant allergens like house dust and pollens which is unavoidable.

Nursing management:

1. Administer antihistamines, decongestants and topical corticosteroids. Caution clients to avoid driving vehicles whenever he or she is on antihistamines or decongestants.
2. Teach the client the proper use of saline nasal sprays by blowing his nose first then administer the nasal medication.
3. Assist the client when he or she is advised for immunotherapy.
4. Encourage a routine cleaning of the house, furnitures and equipments which may house dust and other pollens.
5. There are second generation anti-histamines that are non-drowsing. These are appropriate for clients who cannot avoid working while the allergy is going on. Their work won’t be interfered.

Photo credits: www.nlm.nih.gov

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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