TASK 76: Mr Dallas Walters is a patient on a renal ward where you are the charge nurse.
Age: 51
Marital status: Married with 2 adult children.
Religion & cultural background: Uniting Church & aboriginal background
Admission Date: 16th June 2011, Charles Gardiner Hospital Discharge Date: 22nd June 2011
Diagnosis: Insertion of continuous ambulatory peritoneal dialysis (CAPD) catheter for CRF
Family/Psychosocial: *On Disability Support Pension (DSP) for schizophrenia
*Mental status relatively stable with mild chronic delusions – ‘Aliens are spying on me 24/7’.
*Supportive wife = his carer; has mild intellectual disability
* Live in demountable home in Bunbury Caravan Park *Pt loves fishing and AFL.
Medical History *Mild CRF for 4 years; recently worsened
*Type 2 diabetes. Stable/compliant with oral meds *Removal cataract left eye & insertion of intraocular lens
*Quit smoking and drinking 4 years ago – previously heavy for +++ years.
Medications To be forwarded by medical officer
Management and Progress during Hospitalisation:
*Uneventful procedure; catheter inserted successfully
*Prolonged admission as pt and wife slow to learn management of CAPD
*Hyperkalaemic & needed cardiac monitoring for 2/7 But K+ = 4.0 on D/C (N = 3.5-4.8)
*S/B mental health liaison & their Reg. happy that nil acute changes with pt’s psychosis
Discharge Plan: *+++ CAPD /CRF education for pt and wife
*Monitor for catheter infection or signs of peritonitis
*Important to educate on minimising K+ in diet.
*Observe for signs of ↑psychosis & refer prn
*If necessary, get community aboriginal health worker to reinforce CAPD/CRF education
Writing task: Using information provided in the case notes, write a letter of referral to the renal Clinical Nurse Specialist (CNS) at the Bunbury Community Health Centre for ongoing community care of the patient.
Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/