Coryza can spread through various modes of transmission. It is commonly transmitted through direct contact with an infected person, such as shaking hands or touching surfaces contaminated with nasal or throat secretions.

Additionally, the virus or bacteria responsible for coryza can be transmitted through the inhalation of airborne droplets expelled when an infected person coughs, sneezes, or talks.

Indirect transmission is also possible, where the virus or bacteria can survive on surfaces for a period of time. Individuals can contract coryza by touching contaminated surfaces, such as doorknobs, countertops, or shared items like utensils or electronic devices, and then touching their nose or mouth.

Furthermore, coryza can be transmitted through fomites, objects, or articles that have been freshly soiled by the nasal or throat secretions of infected individuals. This includes items like tissues, handkerchiefs, towels, or shared personal items.

Pathophysiology

The pathophysiology of coryza involves a series of events that lead to the characteristic symptoms of nasal congestion, runny nose, and throat discomfort. It typically begins with the invasion of a virus or bacteria into the upper respiratory tract.

Once inside the body, these pathogens trigger an immune response, leading to inflammation of the mucous membranes lining the nose, pharynx, and tonsils. This inflammation causes the blood vessels in the affected tissues to dilate, resulting in swelling and congestion.

Simultaneously, the immune system releases various chemical mediators, such as histamine, which further exacerbate the inflammation and increase mucus production. The excess mucus accumulates in the nasal passages, leading to a runny nose and postnasal drip.

Further, the swelling and inflammation can block the openings of the sinuses, impairing their drainage and leading to sinus congestion and pressure. This can contribute to symptoms such as facial pain or headaches.

Overall, the pathophysiology of coryza involves a complex interplay between viral or bacterial invasion, immune response, inflammation, and mucus production, ultimately resulting in the hallmark symptoms of nasal congestion, runny nose, and throat irritation.

Signs and symptoms

The signs and symptoms of coryza encompass a range of discomforts typically experienced during the course of the illness:

1. Runny nose and excessive tearing (lacrimation): A patient with coryza often experiences a profuse discharge of fluid from the nose, accompanied by increased tear production, leading to watery eyes.
2. Nasal discharge: Alongside excessive tearing, there is typically a discharge from the nose, which can vary in consistency from thin and watery to thicker and mucoid.
3. General body malaise: Coryza is often accompanied by a general feeling of unwellness, characterized by fatigue, weakness, and a sense of discomfort throughout the body. This malaise can persist for a duration of 2–7 days, depending on the severity of the infection.
4. Nasal congestion: swelling and inflammation of the nasal passages lead to congestion, causing difficulty breathing through the nose.
5. Sneezing: The irritation and inflammation of the nasal mucosa can trigger frequent bouts of sneezing, which serve as a reflexive response to expel irritants from the nasal passages.
6. Sore throat: Inflammation of the throat mucosa commonly results in throat discomfort, pain, and difficulty swallowing, contributing to a sore throat.
7. Body chills: Individuals with coryza may experience episodes of chills or shivering, often accompanied by a mild fever, as the body attempts to fight off the infection.
8. Headache: Sinus congestion, inflammation, and pressure can lead to headaches, which are commonly experienced as a dull ache or pressure in the forehead, temples, or behind the eyes.
9. Coughing: As irritation and inflammation extend to the lower respiratory tract, individuals may develop a cough, which can be dry or productive, as the body attempts to clear mucus and irritants from the airways.

Medical Management

In taking the history of a patient presenting with symptoms suggestive of coryza, the healthcare provider will typically ask about:

History Taking

• Onset of Symptoms: When did the symptoms start? Are they sudden or gradual in onset?
• Duration of Symptoms: How long have the symptoms been present?
• Symptom Description: What specific symptoms are experienced? (Runny nose, nasal congestion, sneezing, sore throat, coughing, fever, headache, etc.)
• Severity of Symptoms: How severe are the symptoms? Are they interfering with daily activities?
• Associated Symptoms: Are there any other symptoms present, such as body aches, fatigue, or loss of appetite?
• Exposure History: Have there been any recent exposures to sick individuals, crowded places, or travel to areas with known outbreaks?
• Medical History: Does the patient have any underlying medical conditions or allergies? Are they taking any medications?
• Social History: What is the patient’s occupation and living environment? Do they smoke or have regular exposure to environmental pollutants?
• Allergy History: Does the patient have a history of allergies to pollen, dust, pets, or other allergens?

Physical Examination

• Vital Signs: Measure temperature, heart rate, respiratory rate, and blood pressure.
• Head and Neck Examination:
  • Inspect the nose for signs of nasal congestion, discharge, or inflammation.
  • Evaluate the throat for redness, swelling, or exudate on the tonsils.
  • Palpate the neck lymph nodes for enlargement or tenderness.
• Respiratory Examination:
  • Auscultate lung sounds to assess for signs of congestion, wheezing, or abnormal breath sounds.
  • Evaluate for signs of respiratory distress, such as increased work of breathing or use of accessory muscles.
• Eye Examination: Look for signs of conjunctivitis (redness, discharge) if present.
• Skin Examination: Check for rashes or other skin abnormalities if indicated.
• Additional Examinations: Perform any additional examinations based on the patient’s symptoms and clinical presentation.

Investigations

In the diagnosis of coryza, investigations may be conducted to confirm the underlying cause and rule out other potential conditions. Common investigations include:

• Nasal Swab: A sample of nasal secretions should be collected using a swab to test for the presence of viral or bacterial pathogens, particularly if a nurse provider suspects a specific infectious cause such as influenza or bacterial sinusitis.
• Complete Blood Count (CBC): A blood test may be performed to assess for signs of infection, such as an elevated white blood cell count, which can indicate an active immune response to infection.
• Throat Swab: In cases where a sore throat is a prominent symptom, a swab of the throat may be collected to test for the presence of bacteria, such as group A Streptococcus, which can cause strep throat.
• Chest X-ray: If the patient presents with symptoms suggestive of lower respiratory tract involvement, such as persistent cough, chest pain, or difficulty breathing, a chest X-ray may be ordered to evaluate for signs of pneumonia or other pulmonary conditions.
• Allergy Testing: For patients with recurrent or chronic coryza symptoms, allergy testing may be performed to identify specific allergens triggering the allergic response. This can include skin prick tests or blood tests (such as IgE antibody testing).
• Nasal Endoscopy: In cases of chronic or severe nasal congestion or sinusitis, a nasal endoscopy may be performed to visualize the nasal passages and sinuses and assess for structural abnormalities or signs of chronic inflammation.
• Viral Testing: In outbreaks or cases where a specific viral cause is suspected, such as during influenza season, molecular tests such as polymerase chain reaction (PCR) may be used to detect viral RNA or DNA in respiratory samples.
• Culture and Sensitivity Testing: In cases where bacterial infection is suspected, cultures of nasal or throat swabs may be performed to identify the specific bacteria involved and determine their sensitivity to antibiotics.

Treatment

The treatment of coryza usually involves managing symptoms and supporting the body’s immune response. While there is no specific cure for coryza, the following measures can help alleviate discomfort and promote recovery:

• Hydration: A nurse should encourage the patient to drink plenty of fluids, such as water, herbal teas, and clear soups. Adequate hydration helps thin mucus secretions, making it easier to clear congestion and maintain hydration levels.
• Salt Gargles: Telling the patient to take some salt gargles can help soothe a sore throat and reduce inflammation. Mix one teaspoon of salt in one liter of warm water and instruct the patient to gargle with the solution several times a day.
• Anti-inflammatory Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin can help reduce inflammation and alleviate pain. A typical regimen may include aspirin, 600 mg, taken three times a day for three days. However, caution should be exercised with aspirin use, particularly in children and individuals with certain medical conditions, due to the risk of Reye’s syndrome and other adverse effects.
• Antihistamines: Antihistamines such as Piriton (chlorphenamine) can help relieve symptoms like sneezing, runny nose, and itching by blocking the action of histamine. The recommended dosage is Piriton 4 mg, taken twice a day for three days. Antihistamines can cause drowsiness, so patients should avoid activities requiring alertness until they know how the medication affects them.
• Decongestants: Decongestants help reduce nasal congestion by constricting blood vessels in the nasal passages, thus drying up secretions and relieving stuffiness. Over-the-counter nasal decongestants or oral formulations may be used as directed.
• Nose Drops: Nasal drops containing ephedrine (for adults) or normal saline (for children) can help relieve nasal congestion and promote the drainage of mucus. These drops should be administered according to the instructions provided and should not be used for prolonged periods to avoid rebound congestion.
• Increased Vitamin C Intake: Vitamin C is thought to support the immune system and may help reduce the duration and severity of respiratory infections. Encourage the patient to consume vitamin C-rich foods such as citrus fruits, berries, and leafy greens, or consider supplementation if appropriate.
• Bed Rest: Adequate rest is essential for supporting the body’s immune response and promoting recovery from coryza. Encourage the patient to get plenty of rest and avoid strenuous activities until symptoms improve.

Nursing Management for Coryza

Aims

1. Symptom relief
2. Prevention of complications
3. Promotion of recovery
4. Patient education and empowerment

Patient Isolation

• Place the patient in a private room with the door closed to prevent the spread of respiratory droplets. Ensure that healthcare personnel wear appropriate personal protective equipment (PPE), including masks, gloves, and gowns, when in close contact with the patient.
• Inform the patient and his or her family visitors about the importance of hand hygiene and respiratory etiquette, including covering the mouth and nose when coughing or sneezing, to reduce the transmission of infectious respiratory droplets.
• Make sure you restrict non-essential visitors and encourage virtual communication methods to minimize contact and prevent the spread of the virus to others.
• The nurses should ensure thorough cleaning and disinfection of patient care areas and equipment to prevent contamination and transmission of the virus to other patients and healthcare workers.

Infection Prevention

• Make an emphasis on the importance of frequent handwashing with soap and water or alcohol-based hand sanitizers for both the patient and healthcare personnel to prevent the spread of infection.
• Educate the patient on proper respiratory etiquette, including covering the mouth and nose when coughing or sneezing with a tissue or the elbow, and disposing of used tissues promptly in a lined waste bin.
• Maintain adequate ventilation in patient rooms and ensure proper disposal of contaminated materials to minimize the risk of airborne transmission by opening up nearby windows.
• Monitor adherence to isolation precautions among healthcare personnel and provide ongoing education and reinforcement to ensure compliance with infection control protocols.

Maintenance of the Airway

• Make sure to position the patient to sit upright or elevate the head of the bed at a 90-degree angle to facilitate drainage of nasal secretions and improve breathing comfort.
• Use humidifiers or steam inhalation to moisten the air and help loosen thick nasal secretions, making it easier for the patient to clear their airway.
• Administer saline nasal drops to lubricate and hydrate nasal passages, facilitating the removal of mucus and relieving nasal congestion.
• Instruct the patient to perform deep breathing exercises to maintain lung expansion and prevent respiratory complications such as atelectasis or pneumonia.

Maintenance of Breathing

• A nurse should regularly assess the patient’s respiratory rate and pattern to detect any signs of respiratory distress or deterioration.
• Administer supplemental oxygen if the oxygen levels are below 95% as prescribed to maintain adequate oxygenation and alleviate respiratory distress if hypoxemia is present.
• Teach effective coughing techniques, such as huffing or controlled coughing, to help clear mucus from the airways and improve breathing.
• If necessary, perform nasopharyngeal or oropharyngeal suctioning to remove excess mucus and maintain a clear airway, especially in patients with difficulty expecting secretions.

Maintenance of Circulation

• A nurse should regularly monitor the patient’s vital signs, including heart rate, blood pressure, and temperature, to detect any signs of hemodynamic instability or complications such as dehydration.
• Encourage the patient to take adequate fluid intake to prevent dehydration, especially if the patient has a fever or is experiencing increased respiratory secretions.
• Assess peripheral perfusion by monitoring skin color, temperature, and capillary refill time to evaluate circulatory status and detect signs of inadequate tissue perfusion.
• Encourage the patient to do some early ambulation and frequent position changes to promote venous return and prevent complications such as venous thromboembolism (VTE) associated with immobility.

Environment

• Make sure that the ward is a clean and clutter-free environment to reduce the risk of infection transmission and promote patient comfort and well-being.
• Make sure the patient is comfortable at room temperature by switching on heaters to promote patient comfort and prevent excessive cooling or overheating, which can exacerbate respiratory symptoms.
• Make sure the ward is free from noise and distractions in the patient’s environment to facilitate rest and promote relaxation, which is essential for recovery.
• Encourage personalization of the patient’s environment with familiar belongings or comforting items to provide a sense of security and enhance emotional well-being.

Observation

• Conduct frequent assessments of the patient’s vital signs, respiratory status, and overall condition to detect any changes or deterioration promptly.
• Document all observations, interventions, and patient responses accurately and promptly in the medical record to facilitate communication and continuity of care.
• Evaluate the patient’s response to nursing interventions and treatments to determine their effectiveness and make necessary adjustments to the plan of care.
• Communicate relevant findings and concerns to the healthcare team, including physicians, respiratory therapists, and other interdisciplinary team members, to ensure coordinated and comprehensive care.

Psychological Care

• Provide emotional support and reassurance to the patient and their family members, acknowledging their concerns and addressing any fears or anxieties related to the illness.
• Listen attentively to the patient’s feelings and concerns, validating their experiences and providing empathy and understanding.
• Encourage the patient to express their emotions and discuss their coping strategies, offering encouragement and positive reinforcement.
• Identify patients at risk of psychological distress or crisis and provide appropriate interventions, including referral to mental health professionals if needed.

Hygiene

• Assist the patient with personal hygiene activities, such as bathing, oral care, and changing clothes, to maintain cleanliness and promote comfort.
• Ensure cleanliness and hygiene in the patient’s environment, including regular cleaning and disinfection of surfaces, linens, and equipment.
• Reinforce the importance of hand hygiene for the patient and their caregivers, providing education on proper handwashing techniques and the use of hand sanitizers.
• Adhere to standard precautions and infection control protocols, including the use of personal protective equipment (PPE), to prevent the spread of infection within the healthcare setting.

Nutrition

• Assess the patient’s nutritional status and dietary intake, identifying any deficits or nutritional needs that may impact their recovery.
• Encourage the patient to eat a balanced diet rich in nutrients, including fruits, vegetables, lean proteins, and whole grains, to support immune function and promote healing.
• If necessary, collaborate with the healthcare team to provide nutritional support, such as oral nutritional supplements or enteral feeding, to ensure adequate caloric and nutrient intake.
• Monitor the patient’s fluid intake and output closely, ensuring adequate hydration to prevent dehydration and support respiratory function.

Elimination

• Assist the patient with toileting needs, ensuring accessibility and privacy, especially for patients with mobility limitations or urinary incontinence.
• Monitor urinary output and assess for signs of urinary retention or dehydration, intervening as needed to promote adequate hydration and urinary function.
• Encourage the patient to maintain regular bowel habits through dietary measures, adequate fluid intake, and physical activity to prevent constipation and discomfort.
• Provide appropriate management strategies for patients with urinary or fecal incontinence, including the use of absorbent pads or briefs and implementing toileting schedules.

Medication

• Administer prescribed medications promptly and accurately, ensuring adherence to the prescribed dosage, route, and frequency.
• Provide thorough medication education to the patient and their caregivers, including information on medication purpose, dosage regimen, potential side effects, and precautions.
• Monitor the patient for any adverse reactions or side effects related to medication administration, reporting any concerns to the healthcare provider promptly.
• Conduct medication reconciliation regularly to ensure accurate and up-to-date medication lists, minimizing the risk of medication errors and drug interactions.

Advice at Discharge

• Follow-up Care: Provide instructions for follow-up care, including any necessary appointments with healthcare providers or specialists for ongoing management of the patient’s condition.
• Home Care Instructions: Educate the patient and their caregivers on home care strategies, including symptom management, medication administration, and when to seek medical attention if symptoms worsen or new symptoms develop.
• Preventive Measures: Reinforce the importance of preventive measures, such as hand hygiene, respiratory etiquette, and vaccination, to reduce the risk of recurrent respiratory infections.
• Community Resources: Provide information on community resources and support services available to the patient and their family, including support groups, home health services, and other healthcare resources for continued assistance and support post-discharge.

Complications

Complications associated with coryza may involve various parts of the respiratory and adjacent systems:

• Lower Respiratory Tract Infections: Coryza can progress to affect the lower respiratory tract, leading to conditions such as bronchitis or pneumonia. This progression may occur when the infection spreads from the upper respiratory tract to the bronchi and lungs, causing inflammation and potentially severe respiratory symptoms.
• Sinusitis: Inflammation of the sinuses, known as sinusitis, can occur as a complication of coryza. The inflammation may result from blockage of the sinus openings due to swollen nasal passages and excess mucus production, leading to sinus pressure, facial pain, and nasal congestion.
• Otitis Media: Particularly common in children, coryza can lead to otitis media, an infection of the middle ear. The blockage of the Eustachian tube, which connects the middle ear to the throat, can promote the accumulation of fluid and bacteria in the middle ear, resulting in pain, earache, and potential complications such as abscess formation.
• Tonsillitis: Infection of the tonsils, known as tonsillitis, can occur concurrently with or as a complication of coryza. The inflamed tonsils may become swollen, red, and painful, leading to difficulty swallowing, a sore throat, and sometimes fever.
• Bronchitis: Coryza can lead to inflammation of the bronchial tubes, resulting in bronchitis. Symptoms may include coughing, chest discomfort, and difficulty breathing. Bronchitis can be acute or chronic, depending on the duration and severity of symptoms.
• Pneumonia: More common in vulnerable populations such as infants and the elderly, coryza can predispose individuals to pneumonia. Infection of the lungs can lead to symptoms such as fever, cough, chest pain, and difficulty breathing. Pneumonia may be caused by viral or bacterial pathogens, and severe cases may require hospitalization and intensive treatment.