By Janella Schroeder RN
It is spring time! Oh the glory! Time to head outside and mow the grass plant your garden, water the flowers, go to the baseball games, and go for a long evening walk after being cooped up all winter long…but what if you have seasonal allergies? This beautiful and magnificent time of year can be miserable for your patients with chronic allergies, 1 in 6 patients to be exact. The multiple symptoms that are associated with allergies such as sneezing, nasal congestion, wheezing and watering of the eyes and dermatitis and/or eczema are the second most reported medical complaint (WOOTEN, 2000).
Do you know what allergies are and how to help?
What are allergies?
Seasonal allergies are an abnormal or over exaggerated response to a substance (dust, mites, pets, mold, pollens, grass…) that most others tolerate without difficulty. When an allergen enters the body the immediate hypersensitivity reaction happens on the surface of mast cells reacting with IgE causing histamine to be released. Histamine causes spasms of smooth muscle, dilation of blood vessels, and increased production of mucus leading to the cascade of allergy symptoms. (WOOTEN, 2000)
What are allergies?
Seasonal allergies are an abnormal or over exaggerated response to a substance (dust, mites, pets, mold, pollens, grass…) that most others tolerate without difficulty. When an allergen enters the body the immediate hypersensitivity reaction happens on the surface of mast cells reacting with IgE causing histamine to be released. Histamine causes spasms of smooth muscle, dilation of blood vessels, and increased production of mucus leading to the cascade of allergy symptoms. (WOOTEN, 2000)
How are allergies diagnosed?
• History: The Who, what, what, when, where and how.
WHO: Who all has these symptoms?
WHAT: What causes the symptoms and what are the symptoms?
WHEN: When are the symptoms the worst?
WHERE: Where are the symptoms the worst?
WHY: Why are they seeking treatment now, are they worse?
HOW: How long have they had these symptoms?
• Physical Exam: A complete physical exam should be performed with special attention to eyes, ears, nose, mouth, throat, and chest.
Common Symptoms: allergic shiners (dark circles under eyes), allergic salute (constant wiping of the nose as if saluting), chronic sniffling, halitosis, postnasal drip, lingering colds, sinusitis, cough, asthma, chronic throat clearing, nasal congestion, snoring, fatigue, rhinitis (Pickett, Hamel, Weaver, & Timmons, 2003). Sneezing, runny nose, watering eyes, itchy eyes, ears, nose (Lillis, 2007).
• RAST Testing: (Radioallergosobent Teasting) A blood allergy test that measures IgE in the patients serum.
• Skin Testing: There are two types of skin tests, the prick and intradermal where very diluted concentrations of allergens are injected into the patient to see if there is a reaction inflected. A patient is considered to be allergic to the allergen if there is a 3mm or larger red wheal on the skin as a reaction (WOOTEN, 2000).
• Skin Testing: There are two types of skin tests, the prick and intradermal where very diluted concentrations of allergens are injected into the patient to see if there is a reaction inflected. A patient is considered to be allergic to the allergen if there is a 3mm or larger red wheal on the skin as a reaction (WOOTEN, 2000).
How can I help my patients manage the symptoms?
Environmental Control:
o Watch the weather and pay attention to pollen, grass, weed and mold levels before going outside (hot, dry, windy weather equals more allergens)
o Limit time outside, especially gardening or mowing-wear a mask if you must do these
o Keep windows and doors to house and car closed
o Install an air purifier and a heap-filter on the heater and air conditioner
o Shower and wash clothes daily to remove allergens from clothing and hair
o Vacuum carpet, curtains, and upholstery often
o Wash bedding often and in the warmest water setting on washer
Environmental Control:
o Watch the weather and pay attention to pollen, grass, weed and mold levels before going outside (hot, dry, windy weather equals more allergens)
o Limit time outside, especially gardening or mowing-wear a mask if you must do these
o Keep windows and doors to house and car closed
o Install an air purifier and a heap-filter on the heater and air conditioner
o Shower and wash clothes daily to remove allergens from clothing and hair
o Vacuum carpet, curtains, and upholstery often
o Wash bedding often and in the warmest water setting on washer
Provide education of medications:
• Antihistamines- can block the effects of the histamine release. Best when taken before exposure to allergen. Available both over the counter and prescription.
• Bronchodilators-given for asthma symptoms associated with allergies, can alleviate bronchospasms.
• Corticosteroids- can be used topically or as a nasal spray to relieve inflammation. Available both over the counter and prescription.
• Decongestants – can reduce congestion in the nasal airway by vasoconstriction. Available both over the counter and prescription.
• Allergy Shots- can help decrease histamine and IgE over time by actually giving small doses of allergen
• Antihistamines- can block the effects of the histamine release. Best when taken before exposure to allergen. Available both over the counter and prescription.
• Bronchodilators-given for asthma symptoms associated with allergies, can alleviate bronchospasms.
• Corticosteroids- can be used topically or as a nasal spray to relieve inflammation. Available both over the counter and prescription.
• Decongestants – can reduce congestion in the nasal airway by vasoconstriction. Available both over the counter and prescription.
• Allergy Shots- can help decrease histamine and IgE over time by actually giving small doses of allergen
References:
Lillis, K. (2007, January). Surviving Seasonal Allergies. Advance for Nurses .
Pickett, ,. A., Hamel, ,. V., Weaver, ,. J., & Timmons, C. (2003). Pediatric Allergies. Advance for Nurses , 5 (1), 29.
WOOTEN, L. (2000, October). Diagnosis & Management of Environmental Allergies. Advance for Nurses ,11.
Lillis, K. (2007, January). Surviving Seasonal Allergies. Advance for Nurses .
Pickett, ,. A., Hamel, ,. V., Weaver, ,. J., & Timmons, C. (2003). Pediatric Allergies. Advance for Nurses , 5 (1), 29.
WOOTEN, L. (2000, October). Diagnosis & Management of Environmental Allergies. Advance for Nurses ,11.
NOTE: This blog post reflects the work of Janella Schroeder, RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.
Posts
No comments:
Post a Comment