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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?
Alterations in ImmunityDonna, a twenty-one-year-old nursing studen.docx

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  • 1. 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?