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?