# A 10-year-old child with allergic rhinitis is experiencing persistent nasal congestion and clear nasal discharge. The child's mother asks the nurse about appropriate interventions to help manage her child's symptoms. Which nursing intervention should the nurse prioritize?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=542593  
> language: ko  
> subject: Child Health

## 문제

A 10-year-old child with allergic rhinitis is experiencing persistent nasal congestion and clear nasal discharge. The child's mother asks the nurse about appropriate interventions to help manage her child's symptoms. Which nursing intervention should the nurse prioritize?

## 보기

1. Encourage the child to blow their nose forcefully to clear secretions
2. Teach the family about environmental allergen control measures **✔ 정답**
3. Recommend increasing dairy products to boost immune system
4. Advise using over-the-counter decongestant nasal sprays daily

**정답: 2**

## 해설

Teaching environmental allergen control is the priority nursing intervention for managing allergic rhinitis in children, as it addresses the root cause by reducing exposure to triggers like dust mites and pollen. Other options are ineffective or potentially harmful.

## 심화 해설

Clinical Judgment
This question evaluates the nurse's need to prioritize interventions addressing the root cause in managing pediatric allergic rhinitis symptoms. The core is a preventive approach focused on minimizing exposure to environmental allergens rather than treating the symptoms themselves. Option 2 is the most effective and safe first-line intervention, directly targeting the disease's pathophysiology (IgE-mediated inflammation) through allergen avoidance education. The other options focus on symptom relief, have unproven effectiveness, or could potentially be harmful.

Memory Tip:
**A**void **A**llergens **F**irst! The golden rule of allergy management is **A**AF (Allergen Avoidance First). Think of environmental control before medication.

KR vs US:
In Korea, while environmental management education for allergic rhinitis is increasingly emphasized, there is still a tendency to rely on medication. In the US NGN/CJMM, environmental control is seen as the core of non-pharmacological intervention, emphasizing the nurse's important educational role. Additionally, thorough education is provided regarding medications not recommended for daily use in children (e.g., nasal decongestants).

## 임상 시나리오

Clinical Practice Guide
When educating the families of pediatric patients with allergic rhinitis, provide specific feasible environmental control measures. For example: "If sensitive to dust mites, cover mattresses and pillows with allergen-proof covers, and wash bedding in hot water at or above 60°C once a week." During pollen season, advise reducing indoor ventilation, and after going outside, have them change clothes and shower.

Caution:
In SATA (Select All That Apply) questions asking about "allergic rhinitis management interventions," "recommending long-term use of decongestant nasal spray" can never be a correct answer. Educate that it should not be used for more than 3-5 days due to rebound rhinitis. Also, remember that "increasing intake of dairy products such as milk" is not an evidence-based intervention.

## 핵심 개념

- **Allergic Rhinitis** — Allergic rhinitis. Inflammation of the nasal mucosa caused by an IgE-mediated inflammatory response upon exposure to allergens. Main symptoms include nasal congestion, clear rhinorrhea, sneezing, and nasal itching.
- **Allergen** — Allergen. A substance that causes an allergic reaction. Common indoor allergens include dust mites, pet dander, and mold, while a common outdoor allergen is pollen.
- **Environmental Control** — Environmental control. A primary non-pharmacological intervention in the management of allergic diseases. It includes physical and chemical methods within the home to minimize allergen exposure (e.g., HEPA filters, allergen-proof covers, humidity control).
- **Rebound Rhinitis** — Rebound rhinitis (drug-induced rhinitis). A paradoxical nasal congestion that occurs after long-term use (usually more than 5-7 days) of decongestant nasal sprays. When the medication is stopped, symptoms worsen, leading to a vicious cycle that prompts more medication use.
- **IgE-mediated Hypersensitivity** — IgE-mediated hypersensitivity (Type I hypersensitivity). Pathophysiological mechanism of allergic rhinitis, asthma, and anaphylaxis. IgE antibodies specific to certain allergens bind to mast cells and basophils, and upon re-exposure, release inflammatory mediators such as histamine.

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