1. Discharge. Any nasal discharge or runny nose? Continuous?
* Is the discharge watery, purulent, mucoid, bloody?
Rationale: Rhinorrhea occurs with cold, allergies, sinus infection, trauma.
2. Frequent colds. Any unusually frequent or severe colds (upper respiratory infections)?
How often do these occur?
Rationale: Most people have occasional colds; thus, asking more precise question yields more meaningful data.
3. Sinus pain. Any sinus pain or sinusitis? How is this treated
* Do you have chronic postnasal drip?
4. Trauma. Ever had any trauma or a blow to the nose?
* Can you breathe through your nose? Are both side obstructed or one?
Rationale: Trauma may cause deviated septum, which may cause nares to be obstructed.
5. Epistaxis (nosebleeds). Any nosebleeds? How often?
* How much bleeding-a teaspoonful or does it pour out?
* Color of the blood- red or brown? Clots?
* Aggravated by nose-picking or scratching?
* How do you treat the nosebleeds?Are they difficult to stop?
Rationale: Epistaxis occurs with trauma, vigorous nose blowing, foreign body. Person should sit up with head tilted forward, pinch nose between thumb and forefinger for 5 to 15 minutes.
6. Allergies. Any allergies or hay fever? To what are you allergic, e.g., pollen, dust, pets?
* How was this determined?
* What type of environment makes it worse? Can you avoid exposure?
* Use inhalers, nasal spray, nose drops? How often? Which type?
* How long have you used this?
Rationale: “Seasonal” rhinitis if due to pollen; “perennial” if allergen is dust. Misuse of over-the-counter nasal medications irritates the mucosa and cause rebound swelling, a common problem.
7. Altered smell. Experienced any change in sense of smell?
Rationale: Sense of smell diminished with cigarette smoking, or chronic allergies.