All posts by Jomon John

Writing Task 4: MR HENRY MCDONALD

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TASK 4: CASE STUDY – NURSES – MR HENRY MCDONALD

Patient History: Born: 23 June 1946

This patient has been in your care and is now going home from hospital Admitted to hospital: 16 April 2008

To be discharged: 18 April 2008 Suffering from Right side hemiplegia

Patient’s History

Myocardial infarction 5 years ago Takes aspirin for hypercholesterolemia

Episodes of transient loss of vision – L eye

Episodes of clumsiness and weakness – R arm – Usually only for a few seconds. Triggered by exertion

Dribbling saliva. Suffers from expressive aphasia. No previous cerebrovascular episodes Long term heavy smoker. Overweight at 115 kg (172 cm) Lives with a partner. No history of depression, self-harm or other psychiatric illnesses

Note: Verbal consultation with patient’s partner reports he has been unusually depressed since onset of symptoms one month ago.

Nursing notes: Visual acuity in L eye was 6/18. Evidence of ischemic retinopathy No other neuro or cardio abnormalities found Color flow Doppler ultrasound of internal carotid arteries show complete Occlusion on L 50% stenosis on R. CT brain scan – normal Dipyridamole added to treatment. Hospital nutritionist planned 1000 cal./day diet for patient Pt. shown lip/ tongue exercises. Pt. encouraged to read aloud

Discharge plan: Patient advised to stop smoking,  Review progress in one month. Might need anticoagulation or extracranial/intracranial bypass surgery if symptoms persist Needs to see GP, District Nurse, Speech therapist

Needs to see Psych – counselling re depression? Antidepressants

WRITING TASK: Using the information in the case notes, write a letter of referral to:  Dr Austin Williams, Western Medical Centre, 1150 Footscray Road, Sunshine, Victoria 3011, requesting adherence to discharge plan. Give full details of the plan. Write 180-200 wards. Use full sentences.

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OET writing task 3: MR JOHN McINTYRE

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MR JOHN McINTYRE – 68 year old                     

Born: 1941

This 68 year old married man has been getting monitored at the Community Health Centre, Richmond. He and his wife are moving to The Lake Retirement Village Bannockburn

11/2001 –         First attended Community Health Centre, Richmond

10/2009 –         Last attended the Centre

DIAGNOSIS:  Hypertension, Congestive cardiac failure,  Chronic obstructive airways disease (COAD)

SOCIAL HISTORY: Married,  Three children; one grandchild, Lives in own home with his wife

Wife has no control over his lifestyle or medication. He resents his children’s advice about the need to change his lifestyle.  Now moving to a self-contained Unit at The Lake Retirement Village (Anticipate this will happen in one week’s time). Apart from a small amount of savings, Mr. and Mrs. McIntyre plan to live on the Aged Pension.  Has been excessively drinking alcohol for past 30 years. Has been excessively smoking (40/day) for the past 35 years. Claims he will stop smoking once he moves to the new Unit. He will try and cut down on the drinking

NURSING MANAGEMENT AND PROGRESS

Medications include diuretics, antihypertensive, vasodilators and bronthodilators

Has received regular monitoring by Community Nurse to achieve medication compliance

Further details in patient’s personal casebook (with the patient)

DISCHARGE PLAN:  Establish contact with a sympathetic medical practitioner

Monitor medication compliance and diet, Encourage patient to stop smoking

Encourage patient to stop drinking, Encourage patient to take moderate regular exercise

WRITING TASK: Mr. McIntyre needs to be monitored by a sympathetic GP so that his present regime continues in his new home. Using the information in the above case notes, write a letter referring the patient into the care of Dr Joan Meagher, General Practitioner, Bannockburn Community Health Centre, 2 Pope Street Bannockburn Victoria 3331. You must use full sentences in your letter – not notes / bullet points. Write no more than 25 lines about 180 to 200 words.

View model answer by Lifestyle Training Centre

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OET writing task 2: Joel Silbersher  

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Name           : Joel Silbersher                   

Age      12

Admitted        : 10 September 2008                          

Discharged : 13 September 2008

Reason for admission: Dehydration, weak rapid pulse, orthostatic hypotension, acetone breath, tachycardia, weakness, fatigue, N & V. abdominal cramps

Diagnosis: Diabetic ketoacidosis

History:  IDDM Type 1; Joel was staying with his friends in Ballarat for the weekend; Insulin injections (Self-administered) neglected, increased sweet and fatty food intake; Stress levels were high; embarrassed by condition.

Nursing Notes: IV fluids, IV insulin administration, blood glucose monitoring; electrolyte replacement; K+ replacement. Pt. condition improved gradually with above, maintained consciousness; glucose added to IV when blood glucose normalized.Pt. commenced on low-fat, low-sugar diet

Discharge Plan:  Pt. and family educated re prevention of future episodes, carry medical ID (indicating diabetic, name of GP, type and dose of insulin) at all times, tell friends and family how to respond in case of hypoglycemia; need for complying with dose and self- medication emphasized; diet plans given, exercise options outlined.

Writing Task: Using the information in the case notes, write a letter of referral to historical GP, Dr. Harry Coleman, St. Kilda Health Clinic, 35 Carlisle St, St Kilda 3182. DO NOT use note form in the letter. Expand the relevant case notes into full sentences. The letter should be approximately 200 words long.

View model answer by Lifestyle Training Centre

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https://goltc.in/oet-writing-correction/

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OET Writing task 1: Robin Williams

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Patient History: Robin Williams 42-year-old man
Admitted to hospital for endoscopic removal of gallstones Admitted 22 May 2005
Discharged 24 May 2005
Today’s date: 25 May 2005
Social History: Married with two children 3,6
Policeman, works shifts at night
Wife away on business overseas for one week No family in Victoria
Nursing Notes: Routine post-operative recovery
Walking normally
Minimal pain-relieved with 3x Panadol daily. Wound healed.
Ultrasound showed operation successful
Discharge Plan: Rest for one week
No heavy lifting
Observe wound for infection. Council childcare for one week
Writing Task
Using the information in the case notes, write a letter of referral to Dr. Phillip Adams, 399 Bourke St, Melbourne, 3000, who will provide follow up care in this case.

View model answer by Lifestyle Training Centre

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

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Alzheimer’s disease

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Patient. Role play. Setting: Community Health Centre Patient: 
You are accompanying your father who is 74 years old and suffering from Alzheimer’s disease for 4 years. You have got a new job in the next state and you need to go as early as possible. There is no one to take care of your father in your absence. You need assistance from the Community Health Nurse to take care of him.
Task: 
• Explain your father’s condition and your worries. 
• Ask if she could do anything for you. 
NURSE. Role play. Setting: Community Health Centre Patient: 
A man has brought his 74-year-old father who is an Alzheimer’s patient for 4 years. He wants you to take care of him or else find out a suitable person who can look after his father when he is away for his job in the other state.
Task: 
• Explain the rules and regulations of the Community Health Centre. 
• Assure him to find someone who can do this for him as early as possible. 
• Enquire about the routines of his father. 
• Ask if there is any particular matter which needs to give extra attention about. 

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Car accident 

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PATIENT. ROLE PLAY. SETTING: Emergency Department, Local Hospital 
You are 35. You were involved in a car accident earlier today and are suffering from whiplash and a headache. You are feeling sorry for yourself and are impatient to be better. 
TASK: 
 Be confused that you have been kept in hospital for so long, given there are no signs of broken bones, cuts or bruises. 
 Ask why you are being given medication. 
 Stress that you want to get better in the shortest time possible. Ask if physiotherapy will shorten the recovery period. 
 Ask about the length of the treatment. How long will it be before you are better? 
 Ask if there is anything else you need to know. 
 Ask if there could be ‘after effects’ or ongoing problems as a result of your accident. 
NURSE. ROLE PLAY. SETTING: Emergency Department, Local Hospital 
This 35-year-old patient was involved in a car accident earlier today and is now suffering from a headache and whiplash (an injury to the cervical spine). He/she is being kept in the hospital for observation but is expected to be discharged later in the day. 
TASK: 
 Find out what the patient thinks are the reasons why he/she is being kept in the hospital. 
 Advise the patient on the reason for taking and continuing to take medication, and ways of managing the pain once he/she returns home (e.g., with heat/ice, analgesics, a collar, etc.). 
 Discuss the best care practices for after the patient leaves the hospital. Describe the benefits of consulting a physiotherapist about exercise and relaxation exercises to loosen up the joints. 
 Explain that you cannot be sure how long the patient will take to recover fully. 
 Stress the importance of complying with the treatment and exercise program. 
 Stress the importance of seeking medical advice if there is any increased pain or discomfort, nausea, vomiting, or vision problems. 

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Bladder infection 

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PARENT. Role play. SETTING: CITY CLINIC 
You have a suspected bladder infection and the doctor has requested a urine sample. You need to get a urine sample from your daughter, who’s only four. When asked, say you need to check the procedure for getting the urine. 
TASK: 
 Confirm that you just need to get her to pee into a container, and then collect the sample from that. 
 Say you’ll follow the nurse’s instructions and ask how quickly you need to bring the urine sample to the clinic. 
 Mention that your daughter keeps getting bladder infections and you don’t think this problem will be resolved soon. 
 Say the doctor gave you lots of advice about hygiene, which you have been following. Admit it’s really difficult to get your daughter to drink anything and she doesn’t like using the toilet at nursery. 
 Mention that you’re glad it’s just a phase and you’ll get the sample done as quickly as possible. 
NURSE. Role play. SETTING: CITY CLINIC 
You see the parent of a 4-year-old girl who has a suspected urinary tract infection (UTI), which she gets frequently. You give the parent a sample bottle and advice on the procedure for collecting a urine sample, which the doctor has requested. 
TASK: 
• Find out the reason for the parent’s request to see you. 
• Outline the urine collection process (e.g., get girl to drink water to fill bladder, collect mid-stream, use sterile sample bottle, etc.). Stress importance of not contaminating the sample (e.g., unreliable test results, cause of bladder infections not identified, etc.). 
• Outline the next steps after sample collection (taken to the clinic within 12 hours, initial dipstick test, full lab analysis if needed, etc.). 
• Give information about bladder infections in children (e.g., common, caused by reluctance to pee/lack of hydration, etc.). Establish what advice the doctor gave the parent (hygiene, cotton underwear, unscented/unperfumed products, etc.). 
• Reassure the parent about the child not using the toilet at nursery (e.g., common phase, will grow out of it as she gets used to the teachers, etc.). Give advice on hydration (e.g., fruit, ice blocks, etc.). 

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Pilonidal sinus 

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PATIENT. Role play. SETTING: General Practice 
You are a 25-year-old apprentice who has a pilonidal sinus (cyst) scheduled for excision next week. You have quite a bit of pain, but you are embarrassed. You have seen the doctor, and you are discussing your treatment and preoperative documents with the nurse. 
TASK: 
 Tell the nurse you feel weak because of this ailment but need painkillers more often than you take them. 
 Emphasise how embarrassed you are and ask if you can still find out what a pilonidal sinus is since you didn’t pay attention when the doctor explained it. 
 Argue that you are very clean and due to your work, you shower in the morning and have a bath at night. 
 Ask what you need to do after the procedure. 
• Reassure the nurse that you will follow the doctor/nursing staff’s advice when in the hospital and adhere to the medication regime, rather than suffer pain. 
NURSE. Role play. SETTING: General Practice 
You are preparing a 25-year-old apprentice for excision of a pilonidal sinus (cyst) next week. The patient is in pain but is embarrassed about the problem and thinks taking medication to alleviate pain is a sign of weakness. You are discussing treatment and preoperative documents, following the doctor’s appointment. 
TASK: 
 Express concern that the patient has pain and views taking analgesics as a “weakness.” 
 Assure the patient that you understand the embarrassment, but doctors and nurses are used to a huge range of medical issues. 
 Explain that a pilonidal sinus is a small opening, a tract on the surface of the skin predominantly caused by an ingrown hair, exacerbated by sweat and prolonged sitting. 
 Reassure the patient that you were not indicating that he/she is dirty, and salt baths post-operatively will help facilitate healing. 
 Provide information on post-operative care (e.g., bleeding, signs of infection, importance of taking analgesia appropriately, use of antiseptic dressings, etc.). 

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IELTS table (writing task 1 – % spent on food)

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The table below shows the proportion of income spent on 4 common items in the UK in 1998.

The proportion of income adults and children spent on 4 common items in the UK in 1998

foodelectronic equipmentmusicvideos
adults25%5%5%1%
men14%10%5%2%
women39%1%5%0.5%
children10%23%39%12%
boys9%18%38%18%
girls11%5%40%17%

The provided table delineates the expenditure patterns of adults and children in the United Kingdom across four distinct categories (food, electronic equipment, music, and videos) during the year 1998, presented as percentages of their total earnings.

In summary, adults allocated a significant portion of their expenditures to food, contrasting with the minimal spending on videos. Children, on the other hand, showed a distinct pattern, emphasizing music spending over food.

Among adults, 25% of expenditures went to food, with men at 14% and women at 39%. Conversely, video spending was minimal, combining at 1%—0.5% for women and 2% for men. Music expenses, 5%, were evenly split at 5% between both genders. Electronic equipment constituted 5%, with women at 1% and men at 10%.

Among children, 39% of income went to music—boys 38%, girls 40%. Conversely, food received the smallest share at 10% (boys 9%, girls 11%). Electronic equipment constituted 23% of expenditures, with boys at 18% and girls at 5%. Videos were accounted for 12%, split with boys at 18% and girls at 17%.

IELTS informal/casual letter

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Q. Write a letter to your friend from a different country. Invite him/her to a party at your home and include the following:
• what the party is about
• give directions on how to get to your place
• suggest how to accommodate him/her Begin as follows: Dear … ,

Sample answer by Lifestyle Training Centre

Dear Matthew,

How’s it going? You don’t even call nowadays! I hope you are not too bad. How’s the pretty girlfriend of yours?

By the way, it’s my mom’s birthday next week, and I would love for you to join the party I’m organising. I’ve got it all figured out! The event will kick off with a poker tournament at 3 o’clock, lasting for about three hours. Following that, some friends and I will be enjoying good music and more.

If you recall the way to my place, fantastic! If not, here’s a quick reminder: Take bus number 13 at Central Station toward Mitchell’s Shopping Centre. After passing the Centre, alight at the bus stop just before the junction on the right. Walk about 100 meters along the same street, and you’ll spot my house at 67 Mitchell Street.

No need to worry about accommodation—I have a room reserved just for you. I am dying to meet with you.. Please do your best to come and early.

Best wishes,

John