NU636 Unit 6: Discussion Allergies

Initial Response

Scenario

A 31-year-old white male comes in for an evaluation of his allergic rhinitis.
He is known to your practice for the last decade.
Presently he is on Flonase nasal spray and Zyrtec daily for his allergic rhinitis.
He owns his own business ‘Dr. Vinyl’ where he specializes in repair of vinyl in automobiles, boats, recreational vehicles, etc.
Exposure to the smell of several of the products he works with has resulted in dissatisfactory management of his typical allergic rhinitis.
On numerous occasions over the last decade he has requested and been given an ‘allergy shot’.
A review of his medical record reveals to you this ‘shot’ has been a steroid injection.
BP 122/74, P 76, R 18

Please develop a discussion that responds to each of the following prompts. Where appropriate your discussion needs to be supported by scholarly resources. Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.

Initial Post

Utilize the information provided in the scenario to create your discussion post.

Construct your response as an abbreviated SOAP note (Subjective Objective Assessment Plan).

Structure your ‘P’ in the following format: [NOTE: if any of the 3 categories is not applicable to your plan please use the ‘heading’ and after the ‘:’ input N/A]

Therapeutics: pharmacologic interventions, if any – new or revisions to existing; include considerations for OTC agents (pharmacologic and non-pharmacologic/alternative); [optional – any other therapies in lieu of pharmacologic intervention]

Educational: health information clients need to address their presenting problem(s); health information in support of any of the ‘therapeutics’ identified above; information about follow-up care where appropriate; provision of anticipatory guidance and counseling during the context of the office visit

Consultation/Collaboration: if appropriate – collaborative ‘Advanced Care Planning’ with the patient/patient’s care giver; if appropriate -placing the patient in a Transitional Care Model for appropriate pharmacologic and non-pharmacologic care; if appropriate – consult with or referral to another provider while the patient is still in the office; Identification of any future referral you would consider making

Support the interventions outlined in your ‘P’ with scholarly resources.

Please be sure to validate your opinions and ideas with citations and references in APA format.

Solution: NU636 Unit 6: Discussion Allergies

The 31-year-old man presents today for follow up of his allergic rhinitis. He reports continued exposure to fumes and chemicals from the products used in his vinyl repair business has led to worsening symptoms despite being on Flonase and Zyrtec daily. Upon review of his chart, it appears previous “allergy shots” have actually been steroid injections.

On physical exam today, his vital signs are within normal limits with a blood pressure of 122/74, pulse of 76, and respiratory rate of 18. His nasal exam shows erythema and swelling of the turbinates bilaterally. No other abnormalities were noted on review of systems.

His allergic rhinitis symptoms have become inadequately controlled over time due to persistent exposure to triggers in his workplace environment (Siddiqui et al., 2022). While Flonase and antihistamines provided benefit initially, the ongoing exposure has overwhelmed this treatment plan. The past steroid injections did not address the underlying immunologic cause of his allergies.

Therapeutics:

Starting omalizumab (Xolair) injections every 4 weeks. Xolair works by binding to and neutralizing immunoglobulin E (IgE), a key driver of the allergic response (Cavaliere et al., 2020). Several studies have found it effective for moderate-severe allergic asthma and chronic idiopathic urticaria when conventional therapies like inhaled corticosteroids and antihistamines…..Please click purchase button below to get full answer for $5

(Solution) NU636 Unit 6: Discussion Allergies