A client with allergic rhinitis asks the nurse what he should do to decrease his symptoms. Which of the following instructions would be appropriate for the nurse to give the client?
A. “Use your nasal decongestant spray regularly to help clear your nasal passages.”
B. “Ask the doctor for antibiotics. Antibiotics will help decrease the secretion.”
C. “It is important to increase your activity. A daily brisk walk will help promote drainage.”
D. “Keep a diary when your symptoms occur. This can help you identify what precipitates your attacks.”
Correct Answer: D. “Keep a diary when your symptoms occur. This can help you identify what precipitates your attacks.”
It is important for clients with allergic rhinitis to determine the precipitating factors so that they can be avoided. Keeping a diary can help identify these triggers. Patients often underestimate the severity of this condition and fail to seek medical therapy. It is important to adequately control AR, especially due to the link between AR and asthma, with poor control of rhinitis predicting poor control of asthma.
Option A: Nasal decongestant sprays should not be used regularly because they can cause a rebound effect. If removing a pet from home is not feasible, isolating the pet to a single room in the house may be an option to minimize dander exposure. It may take up to 20 weeks to eliminate cat dander from home even after removing the animal.
Option B: Antibiotics are not appropriate. Intranasal corticosteroid therapy can be as monotherapy or in combination with oral antihistamines in patients with mild, moderate, or severe symptoms. Studies have shown intranasal corticosteroids are superior to antihistamines in effectively reducing nasal inflammation and improving mucosal pathology.
Option C: Increasing activity will not control the client’s symptoms; in fact, walking outdoors may increase them if the client is allergic to pollen. Avoidance of triggers, especially in those with seasonal symptoms, is encouraged, although it is not always practical. Precautions can be taken to avoid dust mites, animal dander, and upholstery, though this can require significant lifestyle changes that may not be acceptable to the patient.
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