Hay Fever
Transcript: [J10.1] Follow-up & Referrals (Uphold & Graham, 2013) Pharmacological Treatment Hay Fever Seasonal or Perennial Skin Testing IgE antibodies Nasal Smears Serum Allergy Tests Nasal Endoscopy, possible bx Sleep Study and PFTs (NGC, 2015) Viral Infection, Mucosal Erythema & Swelling, Fever, Sore Throat & Hoarseness Rhinosinusitis Fatigue, well nourished Non-Pharmacological Treatment Allergist or Immunologist American Academy of Family Physicians. (2010). Treatment of allergic rhinitis. Retrieved from http://www.aafp.org/afp/2010/0615/p1440.html#afp20100615p1440-f1 Tympanic membrane, no discharge, no tenderness, hearing Objectives RHINITIS is the, "Inflamma- tion of mucus membranes of the nose, usually accompanied by edema of mucosa and a nasal discharge (Uphold & Graham, 2013)." Nose Describe Symptomatology Subjective History & Review of Systems Objective History & Physical Assessment Diagnostic Tests Differential Diagnoses Treatment Plan Review of Systems Social & Family History Follow up in 3-4 weeks or sooner if symptoms worsen, SOB or CP *Diagnosis is usually made from the history and physical ... diagnostic tests are not required * --Allergic or Non-Allergic-- Lung sounds, Cough, Sputum, Equal chest expansion [J01.0] Normocephalic, facial structures, No Sinus Pain (Uphold & Graham, 2013) (Uphold & Graham, 2013) Facial/Sinus pain, Inflammation, Purulent discharge, Fever History of Present Illness General Appearance Neuro & Cardiac General Constitution: Fatigue Psych: Irritability Concentration Memory Work performance Allergic/Immunologic: Known allergens and reactions Food, drug or animal Past allergy tests or tx Rhoades, J. & Jensen, M. M. (2015). Differential diagnosis for the advanced practice nurse. New York, NY: Springer Publishing Company. Respiratory Head PERRLA, Conjuctiva, & Sclera Inflammation, Watery Eyes, Dark Under-Eyes National Guidelines Clearinghouse. (2015). Clinical practice guideline: allergic rhinitis. Retrieved from https://www.guideline.gov/summaries/summary/49010/clinical-practice-guideline-allergic-rhinitis?q=allergic+rhinitis Common Cold American College of Allergy, Asthma and Immunology. (2014). Allergic rhinitis. Retrieved from http://acaai.org/allergies/types/hay-fever-rhinitis Shoua D. Hang BSN, RN (Rhoads & Jensen, 2015) Eyes References Pharynx, Tonsils, Thyromegaly (ACAAI, 2014) Family Predisposition Living Environment & Triggers Indoor Allergens: dust mites, mold, cockroaches, pet dander Outdoor Allergens: Pollen, mold spores, ragweed Irritants: Cigarette smoke, perfumes, gas exhaust Occupational exposure Sleep Changes Fatigue Level Hay Fever Uphold, C. R. & Graham, M. V. (2013). Clinical guidelines in family practice (5th Ed.). Gainsville, FL: Barmarrae Books. Ears Diagnostic Criteria Allergic Cause and 1 or more of the following symptoms: Nasal Congestion Runny Nose Itchy Nose or Sneezing (Uphold & Graham, 2013) Centers for Disease Control and Prevention. ( 2014). Allergies and hay fever. Retrieved from https://www.cdc.gov/nchs/fastats/allergies.htm Throat Physical Exam ...Also Known As... "Seasonal Allergies" "Allergic Rhinitis" (AAFP, 2010) (Rhoads & Jensen, 2015) Saline Nasal Spray Neti Pot Salt gargle or Honey & Lemon Eye Drops Avoidance of Known Allergen Essential Oils Acupuncture Review of Systems [J00] Patent nares & Septum, Pale & Boggy Mucosa, Turnanates, Watery Rhinorrhea, Nasal Creasing Other clinical findings include: Clear Rhinorrhea, Nasal Congestion, Pale Discoloration of the Nasal Mucosa, and Red and Watery Eyes. Physical Exam PQRST of Symptoms: Onset, duration, pattern, and progression Alleviating and aggravating factors Relationship to season/weather, place, time of day, activity, allergen exposure Differential Diagnoses Thank You! (NGC, 2015) Influenza Viral Infection, More Severe symptoms than cold, Fever, Malaise & Myalgia Uphold & Graham, 2013) Itching (mostly eyes, ears, nose, mouth, throat, and skin) Sneezing Runny nose Stuffy nose Trouble Smelling Headache Sore throat Coughing Watery, red, or puffy/swollen eyes Dark circles under your eyes Antihistamines 2nd Generation Oral or Nasal Intranasal Corticosteroids Oral Leukotriene Receptor Antagonist ie. Singulair Decongestants Combination Therapy Immunotherapy SQ or SL (AAFP, 2011) General / HEENT / Respiratory