Week 2 NRNP 6550 i-Human Case Study:
Environmental Allergic Rhinitis
Management in Adult Primary
CareAlternative Case Variant: 34-Year-Old
Female Teacher with Persistent
Symptoms Comprehensive Clinical Guide
for 2025/2026 Academic Year
FULL CASE OVERVIEW
Case Information
Element Details
Course NRNP 6550: Advanced Primary Care of the Family
Week Week 2
Platform i-Human Patients by Kaplan
Case Author Lauren Paluch, DMSc, PA-C
,Element Details
Learning Mode (formative assessment with feedback after each
Mode
section)
Estimated Completion
60-90 minutes
Time
Patient Demographics
Demographic Value
Name Jessica R. (case variant)
Age 34 years
Sex Female
Race/Ethnicity Caucasian
Occupation Elementary school teacher
Insurance Private PPO
Encounter Type Outpatient, primary care
,Demographic Value
Code Status Full code
Chief Complaint
"Constant runny nose and sneezing for the past 6 months. It's worse in the spring
and fall."
History of Presenting Illness (OLDCARTS Framework)
Component Patient Response
Approximately 6 months ago; recalls mild seasonal symptoms for "years" tha
Onset
recently worsened
Location Nasal passages, eyes, throat – bilateral and symmetric
Persistent >4 days/week for the past 6 months; worse in spring (April-May) an
Duration
fall (September-October)
, Component Patient Response
Clear, watery nasal discharge; paroxysmal sneezing (3-10 sneezes in a row);
Character nasal itching; bilateral eye itching and tearing; post-nasal drip causing mild thr
clearing; NO facial pain, NO purulent drainage, NO fever
Aggravating Being outdoors during high pollen count; cleaning the house (dust exposure);
Factors petting cats; entering classroom with plants; morning time (worse upon wakin
Relieving Oral cetirizine 10 mg daily (provides partial relief for 6-8 hours); staying indoor
Factors with windows closed; showering after outdoor exposure
Symptoms present upon waking (nasal congestion, sneezing); improve slightl
Timing
during midday; worsen again in early evening when returning home
Nasal symptoms: 6/10; Eye symptoms: 5/10; Interference: Reports interrupte
Severity sleep due to mouth breathing; daytime fatigue ("I'm tired by 2 PM"); work
productivity reduced by ~30% ("harder to focus on teaching")
Key Positive Findings
• Clear rhinorrhea ×6 months
• Paroxysmal sneezing
• Nasal and ocular pruritus (itching)
• Post-nasal drip with throat clearing
• Seasonal exacerbation (spring/fall)
• Triggers: pollen, dust, cats
Environmental Allergic Rhinitis
Management in Adult Primary
CareAlternative Case Variant: 34-Year-Old
Female Teacher with Persistent
Symptoms Comprehensive Clinical Guide
for 2025/2026 Academic Year
FULL CASE OVERVIEW
Case Information
Element Details
Course NRNP 6550: Advanced Primary Care of the Family
Week Week 2
Platform i-Human Patients by Kaplan
Case Author Lauren Paluch, DMSc, PA-C
,Element Details
Learning Mode (formative assessment with feedback after each
Mode
section)
Estimated Completion
60-90 minutes
Time
Patient Demographics
Demographic Value
Name Jessica R. (case variant)
Age 34 years
Sex Female
Race/Ethnicity Caucasian
Occupation Elementary school teacher
Insurance Private PPO
Encounter Type Outpatient, primary care
,Demographic Value
Code Status Full code
Chief Complaint
"Constant runny nose and sneezing for the past 6 months. It's worse in the spring
and fall."
History of Presenting Illness (OLDCARTS Framework)
Component Patient Response
Approximately 6 months ago; recalls mild seasonal symptoms for "years" tha
Onset
recently worsened
Location Nasal passages, eyes, throat – bilateral and symmetric
Persistent >4 days/week for the past 6 months; worse in spring (April-May) an
Duration
fall (September-October)
, Component Patient Response
Clear, watery nasal discharge; paroxysmal sneezing (3-10 sneezes in a row);
Character nasal itching; bilateral eye itching and tearing; post-nasal drip causing mild thr
clearing; NO facial pain, NO purulent drainage, NO fever
Aggravating Being outdoors during high pollen count; cleaning the house (dust exposure);
Factors petting cats; entering classroom with plants; morning time (worse upon wakin
Relieving Oral cetirizine 10 mg daily (provides partial relief for 6-8 hours); staying indoor
Factors with windows closed; showering after outdoor exposure
Symptoms present upon waking (nasal congestion, sneezing); improve slightl
Timing
during midday; worsen again in early evening when returning home
Nasal symptoms: 6/10; Eye symptoms: 5/10; Interference: Reports interrupte
Severity sleep due to mouth breathing; daytime fatigue ("I'm tired by 2 PM"); work
productivity reduced by ~30% ("harder to focus on teaching")
Key Positive Findings
• Clear rhinorrhea ×6 months
• Paroxysmal sneezing
• Nasal and ocular pruritus (itching)
• Post-nasal drip with throat clearing
• Seasonal exacerbation (spring/fall)
• Triggers: pollen, dust, cats
