Alterations in Immunity
Donna, a twenty-one-year-old nursing student, comes to her nurse practitioner in December with a five-week history of itchy eyes and nasal congestion with watery nasal discharge. She also complains of a “tickling” cough, especially at night, and she has had episodes of repetitive sneezing. She gets frequent “colds” every spring and fall.
Physical Examination
Vital Signs: Afebrile; respiratory rate, pulse, and blood pressure all normal
Skin: Flaking erythematous rash on the flexor surfaces of both arms
Head, Eyes, Ears, Nose, and Throat: Tender overmaxillary sinuses; sclera red and slightly swollen with frequent tearing; outer nares with red, irritated skin; internal nares with red, boggy, moist mucosa and one medium-sized polyp on each side; pharynx slightly erythematous, with clear postnasal drainage
Lungs: Clear to auscultation and percussion
Answer the questions about Donna and her condition and provide a pathophysiological response in the body. Examine and describe the pathophysiology associated with the possible disease.
- What is the possible disease process according to the client’s history?
- What assessment questions would be useful to ask about her medical and family history?
- What evidence suggests that Donna does not have an acute severe infection?
- If Donna has allergic rhinitis, what type of hypersensitivity reaction is involved?
