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A 35-year-old woman presents to the primary care office with a history of nasal congestion that has worsened over time and recurrent sinus infections. She considered herself healthy until about 12 months ago when she began experiencing rhinorrhea, sneezing, and nasal stuffiness that “seems to never go away”. She noticed that her rhinorrhea greatly improved when she attended her family reunion on a two-week Caribbean cruise but returned after being home a few days. She lives with her husband and 5- year-old child. They have two household pets: a dog that has lived with them for the last 4 years and a cat who joined the family 1 year ago. Upon exam, the NP observed eyelid redness and swelling, conjunctival swelling and erythema, allergic shiners (lower lid venous swelling), Allergic crease (lateral crease on the nose) and inflamed nares. PLEASE USE THIS CLINICAL PRACTICE GUIDELINE https://journals.sagepub.com/doi/10.1177/0194599814561600 You may also use a medication administration reference such as Epocrates to provide medication names. Case Study Questions Pathophysiology & Clinical Findings of the Disease 1. Identify the correct hypersensitivity reaction. 2. Explain the pathophysiology associated with the chosen hypersensitivity reaction. 3. Identify at least three subjective findings from the case. 4. Identify at least three objective findings from the case. Management of the Disease *Utilize the required Clinical Practice Guideline (CPG) to support your treatment recommendations. 1. Identify two strongly recommended medication classes for the treatment of the condition and provide an example (drug name) for each. 2. Describe the mechanism of action for each of the medication classes identified above. 3. Identify two treatment options that are NOT recommended (I.e., recommended against).
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