NUR 535 Allergic Rhinitis Concept Map by Kathryn Lusung (prezi.

com)

Zoom-Allergy-Hay Fever-Itching Rash-Welts-Hives.html (rims.edu.in)

Prezi

Results
in:

 Sniffling
 Sneezing
 Coughing

 Swelling
 Runny nose
 Watery Eyes

 Itchy skin
 Itchy Eyes
 Itchy Nose

Caused By:

 Pollen
 Mold, Dust, Dust Mites
 Animals
 Man- Made Materials
 Hay, Straw
 Trees, Glowers, Grass

Treatments
(What we will all do)
Medical Interventions
(What the doctor will do)

 Antihistamines
 Corticosteroids (Nasal Spray)
 Getting rid of Sensitivity
 Avoiding thing (allergen) that makes you sneeze, cough, itch, and have a runny nose or eyes.

Nursing Interventions
(What the nurse will do).
Diagnosis: Ineffective breathing pattern related to sensitivity to an allergen as
evidenced by above signs and symptoms.
Goals (What we want for you):

 At end of shift, patient will identify 3 signs and symptoms requiring treatment.
 At end of session, patient will be able to identify one (or more depending on patient) allergen(s) to
occur.

Interventions (What we will do for you):

 Monitor respiratory status and observe for changes including shortness of breath, coughing,
sneezing, etc.
 Assess patient for a possible narrowed airway through increased respiratory effort.
 Assess pulse oximetry.
 Assess level of anxiety.

Evaluation (What we want to happen):

 Client is able to identify three signs and symptoms requiring immediate treatment.
 Patient is able to identify one allergen that causes symptoms.

Diagnosis: Knowledge deficit related to lack of information evidenced by

continuous exposure to allergen and not taking correct medications.
Goals (What we want for you):

 Patient will verbalize 2-3 causes of allergic reaction at the end of day.
 At end of session, client will state two facts related to each medication that doctor prescribes.

Interventions (What we'll do):

 Assess readiness and current level of knowledge.

 Be alert of signs of avoidance.
 Determine blocks to learning.

Evaluation (What we want to happen):

 Patient is able to verbalize 2-3 causes of allergies.

 Client stated 2 facts related to each medication.
 Willingness to initiation lifestyle.
References
Doenges, M.E., Moorhouse, M.F. & Murr, A.C. (2010). Nurse’s pocket guide:
Diagnoses, prioritized interventions, and rationales. Philadelphia, PA: Davis.
Gulanick, M. & Myers, J.L. (2007). Nursing care plans: Nursing diagnosis and
interventions
(6th ed.). St. Louis, MI: Mosby Elsevier.
PPT - Allergic Rhinitis and co-morbidities in children PowerPoint Presentation - ID:4491925
(slideserve.com)

 Nasal corticosteroids. These prescription nasal sprays help prevent and treat

the nasal inflammation, nasal itching and runny nose caused by hay fever. For
 many people they're the most effective hay fever medications, and they're often the
first type of medication prescribed.

Examples include mometasone (Nasonex) and budesonide (Rhinocort), both

available by prescription, and Fluticasone (Flonase Allergy Relief), budesonide
(Rhinocort Allergy) and triamcinolone (Nasacort Allergy 24 Hour), available over
the counter. The prescription nasal spray azelastine and fluticasone (Dymista)
combines an antihistamine with a steroid.

Nasal corticosteroids are a safe, long-term treatment for most people. Side effects
can include an unpleasant smell or taste and nose irritation. Steroid side effects
are rare.

 Antihistamines. These preparations are usually given as pills. However, there

are also antihistamine nasal sprays and eyedrops. Antihistamines can help with
itching, sneezing and a runny nose but have less effect on congestion. They work
by blocking a symptom-causing chemical released by your immune system during
an allergic reaction (histamine).

Over-the-counter pills include loratadine (Claritin, Alavert), cetirizine (Zyrtec

Allergy) and fexofenadine (Allegra Allergy). The prescription antihistamine nasal
sprays azelastine (Astelin, Astepro) and olopatadine (Patanase) can relieve nasal
symptoms. Antihistamine eyedrops such as ketotifen fumarate (Alaway) help
relieve eye itchiness and eye irritation caused by hay fever.

 Decongestants. These medications are available in over-the-counter and

prescription liquids, tablets and nasal sprays. Over-the-counter oral decongestants
include pseudoephedrine (Sudafed, Afrinol, others). Nasal sprays include
phenylephrine hydrochloride (Neo-Synephrine) and oxymetazoline (Afrin).

Oral decongestants can cause a number of side effects, including increased blood
pressure, insomnia, irritability and headache. Don't use a decongestant nasal
spray for more than two or three days at a time because it can actually worsen
symptoms when used continuously (rebound congestion).

 Cromolyn sodium. This is available as an over-the-counter nasal spray that

must be used several times a day. It's also available in eye-drop form with a
prescription. It helps relieve hay fever symptoms by preventing the release of
 histamine. Most effective when you start using it before you have symptoms,
cromolyn sodium doesn't have serious side effects.

 Leukotriene modifier. Montelukast (Singulair) is a prescription tablet taken to

block the action of leukotrienes — immune system chemicals that cause allergy
symptoms such as excess mucus production. It's especially effective in treating
allergy-induced asthma. It's often used when nasal sprays can't be tolerated or for
mild asthma.

Montelukast can cause headaches. In rare cases, it has been linked to

psychological reactions such as agitation, aggression, hallucinations, depression
and suicidal thinking. Seek medical advice right away for any unusual
psychological reaction.

 Nasal ipratropium. Available in a prescription nasal spray, ipratropium helps

relieve severe runny nose by preventing the glands in your nose from producing
excess fluid. It's not effective for treating congestion, sneezing or postnasal drip.

Mild side effects include nasal dryness, nosebleeds and sore throat. Rarely, it can
cause more-severe side effects, such as blurred vision, dizziness and difficult
urination. The drug is not recommended for people with glaucoma or men with an
enlarged prostate.

 Oral corticosteroids. Corticosteroid pills such as prednisone sometimes are

used to relieve severe allergy symptoms. Because the long-term use of
corticosteroids can cause serious side effects such as cataracts, osteoporosis and
muscle weakness, they're usually prescribed for only short periods of time.

Hay fever - Diagnosis and treatment - Mayo Clinic