Rhinitis

Rhinitis

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  RHINITIS By: Mr. Abhay Rajpoot HOD(Dep. of Medical Surgical) abhayrajpoot5591@gmail.com
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  ANATOMY AND PHYSIOLOGY
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  INTRODUCTION Rhinitis is agroup of disorders characterised by inflammation and irritation of the mucous membrane of the nose. Rhinitis often coexist with other respiratory disorders such as asthma.
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  DEFINITION • Rhinitis isdefined as the inflammation of the mucous membrane of the nose caused by bacterial or virus infection or by an allergic reaction.
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  INCIDENCES • It affectsmore than 50 million people in the united states annually
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  ETIOLOGY • Bacterial infection •Viral infection • Allergens • Alcohol ingestion and odours.
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  Classification • Acute rhinitis •Allergic rhinitis • Vasomotor or drug induced rhinitis.
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  Clinical manifestation • Rhinorrhea •Nasal congestion • Nasal discharge • Sneezing • Pruiritus • Headache
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  HEADACHE RHINORRHEA SNEEZING
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  Diagnostic evaluation • History •Allergen specific immunonoglobulin E antibody. • Nasal cytology. • Physical examination • Nasolaryngoscopy. • Intra dermal skin testing • RAST (Radio-allegro-sorbent Test)
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  RAST NASAL CYTOLOGY NASOLARYNGOSCOPY SKIN DERMALTEST
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  MANAGEMENT • TO REDUCETHE SIGN AND SYMPTOMS AND ITS CAUSES. • TO PREVENT FROM FURTHER COMPLICATION. GOAL-
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  Medical management Treatment basedon its types. o In viral rhinitis prescribed medicine to reduce sign and symptoms. o If bacterial rhinitis administer antibiotics or antimicrobial agents. o If allergic rhinitis nasal glucocorticoids sprays and antihistamines. o Decongestant medicines. o Saline nasal spray. o Intranasal corticosteroids. o Ophthalmic agents.
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  Nursing management
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  • The nurseinstructs the patients with allergic rhinitis to avoid or reduce exposure to allergens or irritants such as dust ,animals ,fumes ,odours, powder ,sprays and smoke tobacco. • Patient education is essential when assisting the patient in the use of all medication. • The nurse instructs the patient in correct administration of nasal medication. • The patient is taught to keep the head upright spray quickly and firmly into each nostrils away from the nasal septum and wait at least one minute before administering the second spray.
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  • In caseof infectious rhinitis , hand hygiene techniques with the as a measure to prevent transmission of organism. • Nurse reviews the value of receiving an influenza vaccination each year to achieve immunity before the beginning of the flu season.
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  NURSING DIAGNOSIS
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  • Impaired comfortrelated to infectious process. • Hyperthermia related to infectious process. • Risk for infection transmission to others related to presence of infectious disease. • Impaired verbal communication related to physiologic changes and upper airway irritation.
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  Impaired comfort relatedto infectious process Goal: To reduce discomfort. intervention rationale Assese for cause of discomfort;malaise fever and muscle ache. In order to gather baseline data and guide further nursing care. Check vital signs of the patient. In order to know the proper function of vital organs. Administer NSAID’s as ordered by physician. In order to reduce inflammation. Administer throat lozenges , salt water or honey and lemon gargles as order for irritated throat. In order to soothen the irritated mucous membrane.
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  • Evaluation :An expected outcome is partially met as evidenced by patient reports on increased comfort and ability to sleep at night.
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  Hyperthermia related toinfectious process. Goal: To maintain the body temperature returns to normal . Intervention rationale Assess the condition of the patient. In order to guide further nursing care. Check vital signs of the patient mainly temperature every four hourly. In order to detect temperature changes early. Monitor the signs of dehydration. Fever causes loss of body fluids. Administer antipyretics as doctors order. In order to reduce temperature.
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  • Evaluation :An expected outome is partially met as evidenced by patients will have temperature lower than 100 F and shows no sign and symptoms of dehydration.
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  Risk for infectiontransmission to others related to presence of infectious disease. Goal : To prevent from infection. intervention rationale Assess pateint’s understanding of infection transmission. In order to understand mode of transmission is essential to prevention. Teach patient and all caregivers the importance of personal hygiene after contact with patient or patient’s belonging. In order to build on patients previous understanding and not repeat information. Covering nose and mouth while coughing or sneezing. In order to prevent spread or infectious droplets. Advice patient and patients relative to do hand washing after contact with patient. Hand washing prevents spread od infection.
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  • Evaluation :An expected outcome is partially met as evidenced by risk for infection of others will be reduced and the patient taking precaution against spread.
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  Impaired communication relatedto physiologic changes and upper airway irritation. Goal: To reduce impaired verbal communication. intervention rationale Advice the patient to use other modes of communication like writing and bells. In order to promote communication. Advice not to take stress on vocal cord. In order to avoid delay in healing. Advice the patient not to talk too much. In order to avoid irritation to mucus membrane. Ask the patient to take steam inhalation every six hourly. In order to promote better healing.
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  • Evaluation: Anexpected outcome is partially met as evidenced by patients sneezing , congestion was reduced and felt better.