160 lbs. BMI: 22.3General: Alert and oriented x 4, well developed and nourish, appears tired but makes eye proper eye contact when communicating with provider. HEENT: Normocephalic. Itching eyes; no hearing deficit, nose congestion with pale boggy mucosa, clear secretion, enlarged nasal turbinates and rhinorrhea. No dental problem noted, erythematous throat void of discharge and tonsils intact. Chest: No SOB, symmetrical.Lungs: Breathing even and unlabored, breath sounds clear in all lobes Heart/Peripheral Vascular: S1/S2, no murmur, palpitation, no rub, dyspnea. +2 pedal pulses, no edema presentMusculoskeletal: Steady gait, good ROM and muscle toneNeurologic: Alert and oriented x 4, Glasgow coma scale: 15Lymph: No engorged lymph nodesImmunologic: Seasonal allergiesDiagnostic TestsSkin test: Allergy to pollen Labs: CBC w/differential for eosinophil, IgE, PFT Allergic Rhinitis: Allergic rhinitis present with symptoms such as sneezing, nasal pruritus, airflow obstruction, clear nasal drainage caused by IgE- mediated reactions to expose allergens and involve mucosal inflammation cause by TH2 cells (Wheatley & Togias, 2015). Based on the presenting symptoms a clinical diagnosis of allergic rhinitis is appropriate for R.B. Allergy rhinitis is made clinically on the basis of characteristic symptoms and can be treated with antihistamine or glucocorticoid. On the basis of evidence, a sensitization skin test will measure the presence of allergen-specific IgE in the blood serum (Wheatley & Togias, 2015). Differential Diagnoses:Non-allergic rhinitis: Although non-allergic rhinitis accounts for approximately 25% of all forms of allergic rhinitis; however, studies have suggested that non-allergy rhinitis is misunderstood and the analytical description is often limited to exclusion of an allergic sensitization. (Poddighe, Gelardi, Licari, Del Giudice & Marseglia, 2016).