TASK 14 Patient       :           Amir Akbari              Age      :           41

Marital status :           Married.                      Religion ethnicity      :           Moslem & Iranian

Admission Date :6^th March 2011, Prince Charles Hospital Randwick       Discharge Date    :22^nd April 2011

Diagnosis        :           Guillain-Barre Syndrome

Family/Psychosocial :           ‘Lives in rented house with Iranian wife & 2 kids (3 & 4) PhD students; pt & wife speak good English support network in Australia.

Children in university childcare 2/7; nil extra days available at center at present

Pt works at service station 3/7. Pt has PTSD issues trauma in mid-80’s – prone to depression and anxiety related to this. Medical History and Medications. Otherwise physically healthy prior to onset of GBS Medication information to be forwarded by doctor

Management and Progress during Hospitalization: *Rapid deterioration and recovery

‘Required ventilation in ICU 3/7 March 20-22’.  At peak of GBS couldn’t move limbs independently

Now muscle tone/strength and needs light assistance with ADLS but can walk slowly with walking frame

Went for regular plasmapharesis and had a total of 5/7worth of IV gamma globulin. Daily physio program including self exercises. Now becoming depressed about his prospects. Wife not coping with financial, study and childcare pressures

Discharge Plan: Continue physio program and encourage pt. to do his, own limb exercises too. Discuss with your team re? Need for psych assessment re? depression. Ensure your s/w is aware of the family and wife’s pressures and provides follow up Halal diet. Pt oxygenation very stable on R/A now but observe for any, in respiratory status or in neurological signs

Writing task: You are the Charge Nurse on the neurological ward where Amir Akbari has stayed for most of his hospital admission. Using information provided in the case notes, write a letter of referral to the Charge

Nurse at Prince Henry Rehabilitation Centre, Malabar Bay where he will be transferred to for rehabilitation after discharge from your ward.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 13:

Patient      :           Mrs. Joy Rafferty       

Age: 65.

Occupation :           Retired clothing machinist

Patient has attended the Community Health Center since her retirement ten years ago. Recently a new Center has opened much closer to her home.

SOCIAL HISTORY:  Widowed since 1984 and has supported the family since her husband’s death

Lives alone in a Housing Commission flat. Has 6 adult children with 3 living nearby in the same suburb

A close family. Social activities are restricted to family occasions. Outside outings are also restricted (Family does her shopping and collects her for outings, etc.). Previously active with the Church and its social circle however this has stopped because the patient can no longer drive.

MEDICAL HISTORY: Benign hypertension over 10 years, now progressing to essential hypertension 180/100 Coversyl 4 mg daily. Rapid weight gain in past year 75 kg to 90 kg

Undifferentiated osteoarthritis type aches and pains, Analgesics required for pain,  Mild depression

FAMILY INVOLVEMENT:  Several meetings with the family to encourage the patient to make social contacts and therefore become less dependent on the family.

Family concerned and overprotective but in agreement with suggestions

DISCHARGE PLAN: Improve her general health status by Increasing exercise regime and stimulatininer

Continue family meetings. Introduce client to suitable interest and activity groups in the area e.g. Aqua aerobics, local women’s chair, Meals on Wheels, parish visiting groups. Encourage and monitor attendance

WRITING TASK : You are the Community Health Nurse who has been looking after Mrs. Rafferty for the past ten years. You are concerned about her increasing isolation and general health. Write a letter referring her to the new Center. The contact persons is: Ms. Rhonda Johns, RN., Community Health Care, 25 River Street, Clayton, Vic: 31804

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

We hope this information has been valuable to you. If so, please consider a monetary donation to Lifestyle Training Centre via UPI. Your support is greatly appreciated.

Would you like to undergo training for OET, PTE, IELTS, Duolingo, Phonetics, or Spoken English with us? Kindly contact us now!

📱 Call/WhatsApp/Text: +91 9886926773

📧 Email: [email protected]

🗺️ Find Us on Google Map

Visit us in person by following the directions on Google Maps. We look forward to welcoming you to the Lifestyle Training Centre.

Follow Lifestyle Training Centre on social media:

• Facebook
• Instagram
• YouTube

Thank you very much!

TASK 11: Name        :           Cheryl Cook                                                  D.O.B  :           2/11/1970

Admitted         :          7th August 2008 Discharged   :          9th August 2008 Diagnosis     :           Laryngities

Patient History: Accompanied by husband to hospital, suffering from hoarseness, sore throat, dry cough, voice loss, lasting 18 days, smoker (0.5 / day), alcohol intake – 30

History of upper-respiratory infections, hypothyroid since 2005-controlled with thyroxin.

No allergies but suffers mild asthma-well controlled, no major attacks for four years

Social History: Married to Christopher, two children aged 5 and 8: works as jazz singer and in loud busy bar, worried about possibility of not being able to keep singing, important concerts next month

Nursing Notes: Laryngoscopy – found vocal cord polyps/nodules; given lozenges (Strepsils-every 4 hours) Corticosteroids (Prednisone inhaler every 6 hours) given water hourly

Discharge Plan: Patient to see ENT specialist re polyps: if any pain or problems in future to see a doctor immediately told to avoid smoking alcohol/caffeine/decongestants until recovered, Continue prednisone for next 7 days strepsils as needed. Rest voice completely, avoid clearing throat, avoid whispering, avoid upper respiratory infections, recommendation to stop bar work-patient reluctant to do this, drink plenty of fluid, gargle salt water, hot steamy shower-install humidifier in home (use bowl of hot water for inhalations 5 mins 2 x daily)

Writing Task: Using the information in the case notes, write a letter of referral to Dr. Tim Richards, 28 Acacia Ave, Box Hill 3128

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 10. Tracy Chapman is a 20 year old single woman with 3 children. She was admitted to an appendicectomy and has recovered, She is ready to be discharge home

Name   :           Tracy Chapman                                  Age      :           20 years

Admitted         :           18 April 1990                          Discharged      :           23 April 1990

Diagnosis        :           Acute Appendicitis                 Operation        :           Appendicectomy 18 April 1990

Social background: Single with 3 children aged 18 months, 3 years and 4 years Lives in a rented flat with her children. The father of the children has no contact Only income is the Single Mother’s Pension Has several friends who all works full time. Tracy’s mother is caring for the children but will be returning to her home in the country when Tracy comes home.

Nursing Management and progress: Routine post-operative recovery Tolerating light diet and fluids Walking normally. Minimal pain relieved with 2 pandol 3 times a day Wound healed sutures removed

Discharge Plan: Rest, Moderate exercise, No heavy lifting or activity for 6 weeks High protein diet

Observe wound for infection Council “home help”

Writing Task: Tracy will require support and assistance to manage her children when she returns home.

Using the information in the discharge summary. Write a letter referral to the community health nurse. Raw Willis, who will assist Tracy at home.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 9.  Patient History: Victoria Flangan is a patient in your care, who is ready for discharge and will be transferred to a nursing home

Name   :           Mrs. Victoria Flangan            

Age      :           88 Years (D.O.B. 21/10/20)

Admitted         :           16/02/08

Diagnosis        :           dementia and side effects of medication for Parkinson disease (Levodopa with carbidopa 100/25 qid)

Reason for admission  :           confusion, aggression and paranoid behaviour

Treatment: Observed 4 hourly, Medication changed to Bromoryptpine mesylate 1.25 mg nightly for one week, 1 to 2.5 mg nightly 2nd week, Now 1.9 mg.bd.

Assessed for dementia. Assessed for nursing home care

Promotion of physical movement. Exercises to strengthen muscles involved in speaking and swallowing

Nutritional therapy, plenty of roughage.

Social Background

Previously living independently with 89 year old husband (Tom). He is finding it increasingly difficult to cope with aggressive behaviour. Pt. disoriented and waking at night to dress for work or going outside to garden etc. Two children, both living in the UK and visiting once a year.

Nursing Notes:

Confusion, aggression and paranoid behaviour overcome with change of mdx. Dementia symptoms continue memory loss, disorientation etc. Wears glasses Wears hearing aids

Walks with stick/walking frame

Discharge plain         Transfer to nursing home       

Diet: foods that are appetising, easily chewed and swallowed

Physiotherapy, improve muscle tone + Strength of muscles for speaking and swallowing

Elevated toilet seat                 

Upright chair with arms: back elevated Slip-on shoes           

Avoid rugs on floor

Social work visits

Using the information in the case notes, writes a letter of referral to The Admissions Officer, Torquay Nursing Home, 77 Jan Juc. St. Torquary 3763

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 8            TODAY’S DATE   :   21.05.00

You are Grace Jones, a qualified nursing sister working in Ward C26, Princess Alexandra Hospital Contact, Ph: 07 3807 7642, Annette Macnamara is patient in your care, Read the case notes below and complete the writing task which follows

Name   :           Annette Macnamara

Address :          Unit 15, 66 Smart St. West End          Phone  :           (07)33795926

Social Background

Single Age Pensioner – Recently moved to a small flat in new suburb. House she rented for 10 years was sold. Feels increasingly lonely and isolated-rarely sees neighbours-transport problems make it impossible to continue to attend bowls and bridge clubs. Next to kin Niece Stella Attola, Ph 07559847216 lives and works in Southport-generally visits one a fortnight

Medical History

Date of Admission      :           20.05.2000                                          Date of Discharge       :            22.05.2009

Provide no complications and home assistance arranged. Admitted to hospital following fall. Slipped and fell while descending stairs to put out garbage. X-ray revealed fractured right wrist-Laceration to left hand caused by broken glass. Stitches required-Severe bruising of right shoulder and lower back

Medications: Karvea 150 mg daily am – history of high blood pressure now controlled Normison 10 mg-1 nightly for Insomnia when required

Pain relief-2 Panadol 4 hourly while pain persists.

Discharge Plan: Organise daily visits from Blue nursing Service to assist with showering and to dress hand wound. Social Worker to organise meals on Wheels and physiotherapy. (Niece will visit at weekend to help with housework and shopping. Stitches to be removed and situation to be reviewed at Out Patient Department appointment 10.30 am 31.05.09

Writing Task: Using the information in the case notes, write a letter to the Director, Blue Nursing Service, 2 Sydney Street, West End. Do not use note form in the letter. Expand on the relevant case notes explain patients background and medical history and the assistance requested.

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 7 Name            :           Kim Morley               Age      :           36

Admitted        :           10 November 2008                  Discharged     :           11 November 2008

Reason for admission Mino RTA after falling asleep at the wheel-Diagnosis OSA

HISTORY:  Loud snoring, excessive daytime sleepiness; depression; father had OSA; obese 150 kgs- no weight reduction techniques successful over last 5 years. No history of asthma, emphysema or chronic cough suffered from gout two years ago and psoriasis: alcohol 3-4 glasses daily, usually wine; up to four coffees/day; no medications; Divorced, 2 children; builder owns own business; smoker- 1 pk/day 15 years; had malaria 1998, appendix out 1990. No allergies.

Examination: Sleep study (overnight/daytime split night polysmnography) confirmed OSA, face mask used claustrophobia and discomfort so nasal trumpets used. EEG, EOG, chin and leg EMG EKG airflow, thoracic and abdominal recorded. Pt. given Ambien for test.

 Discharge Plan: Avoid sedatives, hypnotics and narcotics unless sleep apnoea treated No operation of heavy machinery or driving unless sleep apnoea treated See dietitian re: weight loss plant, healthy diet, exercise

Use heated humidifier in bedroom

Give up Smoking – Given info about Quit program Cut down alcohol and caffeine. Use nasal decongestant

See sleep disorder specialist for a CPAP machine.

Writing Task: Using the information in the case notes. Write a letter of referral to the sleep disorder specialist, Mrs. Ton wisdom, 23 Wellman St. Camberwell, 330

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

TASK 5 NURSE IN OUTPATIENTS DEPARTMENT OF LARGE HOSPITAL

PATIENT: STEPHANIE EMERSON-ECZEMA

Patient’s Name           :           Stephanie Emerson 8 year old

Date of Birth              :           22 January 2002

Social History             :           Lives at home with parents. Loves swimming, gymnastics, netball

Medical History        :           No major illness; get hayfever during spring time

Medication History     :           Nil

Family History          :           Father gets asthma and is one steroid medication

Current problem, 10 October 2009    : Stephanie’s eczema has flared up. Has been on gluten free diet. Eczema rash all over the trunk of her body as well as arm/knee joints. Now advised to use Tubifast wet wrapping with an emollient. 50% white soft paraffin and 50% emulsifying ointment. Suggested Epaderm. In addition to Tubifast wet wrapping on toso, use Lociod Lip cream atopically on crease-folds of elbows and knees. To be monitored by Community Nurse

Previous History21 December 2008 :           Hayfever. Temp 39.5o c P. 85 BP 150/90

Given water-based Nasacort AQ (Triamcinolone acetonide), to be sprayed into nasal passage once a day (mornings)

3 February 2009        :           Fuss like discharge from nose: cannot smell anything

Headache above eyes. diag: Sinusitis Amoxycilin-10 days course. Plus Nasacort AQ

26 September 2009:Mother brought Stephanie into surgery-skin rash on back of knees and inside elbows.

Diag: Eczema. Advised to see a dietitian re suitable diet. Atopic hydrocortisone cream. Lociod Lipocream.

Writing Task: Write a letter to the Community Nurse, Springvale Community Health Centre, 1075 Waverley Road, Springvale, Vic 3171. Outline the treatment Stephanie has had so far and request the Community Nurse to visit Stephanie’s home to make sure her mother is applying the cream and tubifast correctly. Community Nurse to remind patient’s mother to use Tubifast as a dry wrapping (With atopic Lociod Lipcream) and as a wet wrapping at night when Stephanie goes to bed At night – use Epaderm. No cats or dogs allowed in Stephanie’s bedroom. Follow gluten free diet. Review household furnishings no carpets or dust catching furniture would be best

Submit your OET letters for correction: (for a minimal fee)
https://goltc.in/oet-writing-correction/

We hope this information has been valuable to you. If so, please consider a monetary donation to Lifestyle Training Centre via UPI. Your support is greatly appreciated.

Would you like to undergo training for OET, PTE, IELTS, Duolingo, Phonetics, or Spoken English with us? Kindly contact us now!

📱 Call/WhatsApp/Text: +91 9886926773

📧 Email: [email protected]

🗺️ Find Us on Google Map

Visit us in person by following the directions on Google Maps. We look forward to welcoming you to the Lifestyle Training Centre.

Follow Lifestyle Training Centre on social media:

• Facebook
• Instagram
• YouTube

Thank you very much!