TASK 7 Name : Kim Morley Age : 36
Admitted : 10 November 2008 Discharged : 11 November 2008
Reason for admission Minor 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

Model answer by Lifestyle Training Centre

Mrs. Ton Wisdom
Sleep disorder specialist
23 Wellman, St. Camberwell, 330

11/11/2008

Dear Mrs Wisdom,

Re: Ms Kim Morley, aged 36 years.

I am writing to refer Ms Morley, who requires assessment and management, following her discharge today. She is currently recovering from a minor road traffic accident that occurred after she fell asleep at the wheel.

During her hospitalisation, Ms Morley underwent an overnight and daytime split-night sleep study due to her excessive daytime sleepiness and loud snoring. Polysomnography confirmed a diagnosis of obstructive sleep apnea, with a noted familial history. To accommodate her claustrophobia and discomfort, nasal trumpets and a face mask were used. Additionally, she was administered Ambien.

Ms. Morley is divorced and has two children. She smokes a pack of cigarettes daily and consumes up to four glasses of coffee and wine each day, which she is advised to quit. Her medical history includes gout and psoriasis, but she has no known allergies.

Based on the above information, please assist Ms. Morley in managing her condition. She should avoid driving or operating heavy machinery. Additionally, she is advised to use a nasal decongestant and a heated humidifier in her bedroom. Until her condition is treated, she must refrain from using sedatives, hypnotics, or narcotics. If you have any further questions, please feel free to contact me.

Yours sincerely,
Registered Nurse.

Word count: 198

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