Allergic rhinitis
Definition:
Allergic rhinitis is associated with an IgE-
mediated inflammatory response to allergen
exposure. It is a risk factor for the development
of asthma. Rhinitis can a have major impact on
quality of life, including sleep impairment and
decreased work and school performance. It is
also one of the most common chronic
conditions affecting people in the United States
with estimates of 35 to 50 million people
affected; incidences are increasing, especially
among the pediatric population (Muraro,
Lemanske, Hellings, et al., 2016).
In the Philippines, the reported overall
prevalence of allergic rhinitis is 20% based on a
National Nutrition and Health survey conducted
in the year 2008.
Chronic rhinitis/perennial rhinitis- occurs
intermittently or continuously when a person is
exposed to certain allergens.
In the Philippines hay fever season is usually
during the wet months when the wind from the
rain carries pollens with it to different places,
including inside your home.
Causes:
The triggers that usually causes allergic rhinitis
are airborne allergens:
 Plant pollens
 Molds
 Dust
 Animal dander
 Wool
 Air pollutants
(Ignatavicius, D., & Workman, L. (2006).
Medical-Surgical Nursing: Critical Thinking for
Collaborative Care (5th ed.))
Risk factors:
 Genetics
 Environmental
Clinical manifestation
 Rhinorrhea
 sneezing
 nasal congestion
 Itchy, watery eyes
 Headache
 Pressure over the sinuses
 Dry, scratchy throat and pharyngitis
 Fatigue
 Fever(rare)
(Ignatavicius, D., & Workman, L. (2006).
Medical-Surgical Nursing: Critical Thinking for
Collaborative Care (5th ed.))
Labs and diagnostics
 CBC- indicate presence of allergic
response by increased eosinophils.
 RAST test- used to detect specific IgE
antibodies in the blood that are
associated with allergies.
 Allergy testing
a. Skin testing -show specific allergens
the causing reaction. Can be done
through either intradermal or
scratch testing.
Scratch testing – scratch or prick test can show
immediate hypersensitivity reaction to allergen.
Allergen is introduced through a prick caused a
localized reaction (wheal) when test result is
positive. Results are determined after 15-20
min.
Site: inside of the arm or the back
Intradermal testing – reserved for substances
that are strongly suspected to cause allergy but
did not test positive with scratch test.
(Ignatavicius, D., & Workman, L. (2006).  Instruct client to avoid substances that
Medical-Surgical Nursing: Critical Thinking for cause allergic reaction.
Collaborative Care (5th ed.))  Discuss methods to control
environment allergens (dust, pollens,
molds, etc.)
Interventions  Instruct client and SO on how to avoid
situations that put the client at risk and
1. Avoidance therapy
how to respond if an anaphylactic shock
 Urge client to avoid direct or
should occur.
close contact to allergens that
(Ignatavicius, D., & Workman, L. (2006).
cause allergic rhinitis.
Medical-Surgical Nursing: Critical
 Make environmental changes Thinking for Collaborative Care (5th
>washing bed regularly ed.))
>thorough cleaning of the room
>using air purifiers
>keeping pets out of the
bedroom
2. Symptomatic therapy
 Focuses on managing
symptoms and making the
client feel comfortable
Drug therapy
a. Decongestants
b. Antihistamine
c. Corticosteroids
d. Mast cells stabilizer
e. Leukotriene antagonist
3. Desensitization therapy
/Immunotherapy (“allergy shots”)

(Ignatavicius, D., & Workman, L. (2006).

Medical-Surgical Nursing: Critical Thinking for
Collaborative Care (5th ed.))

Allergy management

 Identify known allergy and usual

reaction
 Notify caregivers and healthcare
providers of known allergy.
 Provide medication to reduce or
minimize allergic response.
 Assist with allergy testing, as
appropriate
 Administer allergy injections as needed.