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Donna visited the nurse practitioner with a prolonged history of having the watery nasal discharge with a range of associated symptoms. The woman’s vital signs are normal, but her eyes, nose, and throat are red and swollen. Donna’s condition and associated pathophysiological processes should be discussed in detail in this case.
While referring to Donna’s history, it is possible to state that the possible disease causing the observed symptoms is allergic rhinitis. In response to the allergen, Donna’s T-cells release IgE antibodies that cause the production of such special chemicals as histamine in order to attack allergens (Greiner, Hellings, Rotiroti, & Scadding, 2012). These chemicals usually provoke such symptoms as the nasal congestion, itchy eyes, sneezing, and coughing observed in Donna’s case because of making the special muscles of the airways narrower and tightened (Hellings, Fokkens, Akdis, Bachert, & Cingi, 2013). As a result of this process, the secretion of mucus becomes increased due to histamine effects, and this chemical causes nasal congestion and the intense watery nasal discharge. The mucosa becomes red and moist, and the pharynx becomes erythematous, as it is in the case of the young woman (Rondon, Campo, Togias, Fokkens, & Durham, 2012). It is important to state that these processes also cause Donna’s night cough. In addition, it is necessary to note that the observed polyps are typical of allergic rhinitis because of the reactions of mucosa to histamine (Greiner et al., 2012).
Donna states that she has such “colds” in spring and fall. Thus, it is possible to speak about the seasonal allergic rhinitis (Rondon et al., 2012). However, the additional test is required in order to determine the group of allergens that can cause Donna’s allergic rhinitis. From this point, the assessment questions that need to be asked in Donna’s case are about her personal history of allergies and asthma. It is also important to ask about any allergies and “cold” symptoms that are observed not only seasonally. In addition, it is necessary to ask about the family history of allergies because allergic rhinitis is usually observed in persons having the relatives with this condition (Rondon et al., 2012). The answers to these questions will provide the additional information on the case to propose the effective treatment for the woman.
In spite of the fact that Donna’s symptoms can be associated with a severe acute infection, the woman has another disease. The reason for not focusing on the infection as the cause of the problems is that the woman’s vital signs are normal, she has no fever, the respiratory rate is normal, and lungs are easily auscultated (Greiner et al., 2012). While assuming that Donna has allergic rhinitis, it is possible to state that Type I or immediate hypersensitivity is observed (Greiner et al., 2012). Donna’s rash as an example of the atopic dermatitis is also associated with Type I hypersensitivity.
While referring to the conducted analysis of Donna’s symptoms, it is possible to state that the woman has the allergic rhinitis that can be of the seasonal nature or the perennial nature because Donna visited a nurse to ask for the assistance in December, and the rhinitis was observed during five weeks of the late fall. Thus, the additional test in order to find out the causes of the allergy is important for Donna.
References
Greiner, A. N., Hellings, P. W., Rotiroti, G., & Scadding, G. K. (2012). Allergic rhinitis. The Lancet, 378(9809), 2112-2122.
Hellings, P. W., Fokkens, W. J., Akdis, C., Bachert, C., & Cingi, C. (2013). Uncontrolled allergic rhinitis and chronic rhinosinusitis: Where do we stand today? Allergy, 68(1), 1-7.
Rondon, C., Campo, P., Togias, A., Fokkens, W. J., & Durham, S. R. (2012). Local allergic rhinitis: Concept, pathophysiology, and management. Journal of Allergy and Clinical Immunology, 129(6), 1460-1467.
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