Ms Patricia Styles OET letter

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TASK 59. You are a nurse visiting Ms Styles at her home who is taking self care at home

PATIENT HISTORY. Name: Ms Patricia Styles

Age:04/08/1955 (63 years)

MEDICAL BACKGROUND: Hypertension diagnosed in 2012, on Carpinol medicine, blood pressure 2014 (190/100) Now BP under control (140/90)

Diabetes Mellitus diagnosed in 2009 (Type II), taking oral hypoglycemic (Metformin+Glipizide)

Depression diagnosed first in 2015, depressed after her husbands

death, attends medical counseling for mood swings and diabetes mellitus management

SOCIAL BACKGROUND: Hobbies walking, reading

Lives alone, no close relatives, her cousin helps her sometimes Medications

Carpino! 6.25 x 2 times daily Metformin- 500mg x 2 times daily Glipizide 10mh x I daily

MEDICAL HISTORY: On 07/04/2018 she admitted in Green Valley Hospital with chest pain (pleuritic),shortness of breath(SOB), tiredness.

Management: Glucose monitored regularly, sugar and BP (well controlled)

Blood test: ESR (24). Creat (2.0). Platelets (Stress/inflammation)

Oral throat swab Type B influenza Chest X-ray Normal Echocardiogram Pericarditis

Diagnoşis: Type B influenza plus pericarditis          

Treatment:  IV saline, Antibiotics

Discharged on 09/04/2018 advising further follow up home visits

She was on self home care after discharge. She was keeping well and the home nurse left her 2 days ago.

14/04/2018 Home visit: Subjective:Ms Styles feels tired and has chest pain Examination Unwell, Chest pain (when sitting), SOB, fatigue Vital signs Mild temperature (38), HR-122, RR-28. BP-180/90 Assessment ?? Relapse/Complication pericarditis

Plan: Refer patient to Newtown Hospital Emergency Department (nearest hospital) Inform emergency doctor about patients: Medical history Medications Past history

WRITING TASK: Write a referral letter for MS Styles to the Emergency Doctor on Duty requesting urgent assessment and management of her pericarditis. Address the letter to: Emergency Doctor on Duty. Newtown Hospital, Comer Street, Newtown 1104.

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Mr. James Tung OET letter

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TASK 58

You are a Nurse in Community health clinic, Brisbane, Mr. James Tung is a regular patient at your clinic

Name: Mr. James Tung

Age:70 Years

DOB:22/11/1948

Social History: Aged pensioner lives in a Storey House. Wife died 2 years ago, I son in USA Working as software engineer. Used to play bridge, chess but now doesn’t go out much

Medical History: Appendectomy at the age of 45 due to acute appendicitis

Pneumonia 2016 August.  Fall while going to shop, Broken arm

28/11/2017: Complained of worsening back pain for 2 weeks Only able to walk 10 minutes

pain diminishes when sitting. pain radiates – Lower-spine to hip and legs

X-ray taken: Ref to neurosurgeon Ref to physiotherapist

3rd December: X-ray-spinal stenosis. Neurological Assessment-severe lower back pain affecting lower legs.

Treatment options discussed; surgery epidural steroid injections and physiotherapy Patient refused physiotherapy, surgery. Prescribed ibuprofen. Dose of epidural steroid injection methylprednisolone 50mg with 1% Procaine

25/12/2017: Minor improvement in pain. 

has been taking double dose in medication. Not doing exercise as suggested

Explained not to taken more than required dose. Next epidural in March

13/12/2018: Patient extremely angry.   Wants to increse the dose of medication Decreased Mobility

Unable to stand long time for shower. Unorganized dressing.

Suggested OT Assessment but patient refused. Community nurse to Monitor his medication compliance, Assess his needs. Encourage him to see OT and physiotherapist Meals delivery service to be arranged.

Writing Task: Write a letter to a community nurse Ms.Pansford, Community Nursing, Center, 78 Masterson St.Acacia Brisbane 4110, pay home visit twice a week

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Stanley Williams OET letter

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TASK 57:
Patient Name: Stanley Williams.   D.O.B – 20.03.1956

Patient History– Stanley Williams is a Builder and regular patient your country medical centre in Mildura, 350 km north of Melbourne. Present occasionally with lower back pain clears no with anti inflammatories. Had spinal X-ray 1 year ago – showed some narrowing of L4-5 and sign of osteoarthritis in L5-ST)

las NIDOM controlled by diet and exercise

23.02.2007: Sudden onset lower back pain yesterday while working. Worse than usual back pain.

Worse L side with radiation down back of L.thigh. Took Nurofen which settled pain but worse this morning. Couldn’t go to work puts hand on L hip when walking, Walks slowly. Tender around lower spine and spinal muscles. SLR positive on L side at 45 degrees. Legs normal power and reflexes. Pain inhibiting lumbar flexibility and extension

Assessment: Possible disc prolapse or nerve root irritation from facet joint dysfunction

Treatment: Bed rest 2 days, paracetamol and anti inflammatory 50 mg and daily with food, hot water bottle on back, come back in 2 days

25.02.2007: No change in pain in the back or leg pain, neurological examination done

In pain but says it’s no worse than before, still some difficulty with Lside SLR 40-45 degrees

Assessment : No improvement of symptoms but no worsening

Treatment: Continue treatment as before.NSAIDS increased to 3 x daily. Return in 2 days for review

27.02.2007: No change in back pain, radiating leg pain worse, most constant, esp at night, urine test showed glycosuria 2 + (usually none). Obviously in pain, difficulty with movement, walks slowly. Still tender and with decreased motion. SLR 30 degrees L side. Random blood glucose taken 12 mmol worse.

Assessment: Symptoms worse. Inactivity making diabetes symptoms. Treatment: Continue treatment as before Review in 5 days. Paracetamol/Codeine 30 mg x 6 hourly. Reason for diabetes symptoms worsening exolained diet modification recommended because of inactivity

29.02.2007: Called urgently to patient’s home, pain increased overnight in back and down L.leg, pain not controlled by any medications, lower Leg has become numb.

-Pain caused inability to get out of bed. SLR 10 degrees L.leg and 30-40 degrees R. leg. L. leg also no ankle reflex, decreased toes extension, decreased ankle flexion, decreased pin prick sensation in areas. Random blood glucose increased to 14mmol

Assessment – Condition not relieved by medications Signs Indicate nerve root compression and disc prolapse

Treatment: Ambulance transport to Royal Melbourne Hospital emergency department arranged, phoned orthopaedic registrar and arranged for hospitalisation and orthopaedic assessment.

Writing Task: Using the information in the case notes, write a letter of referral to Dr. Kate Murray, Royal Melbourne Hospital, Grattan Street, Royal Park 3054

View sample answer by Lifestyle Training Centre

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Gemma Brown OET letter

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TASK 56

Today’s’ Date  ; 26/05/2017   

Patient Details:     

Name     : Gemma Brown.     

DOB      :            19/01/1990

You are the nurse in charge of mental health ward at Robina Private Hospital. Gemma Brown is under your care as she was admitted with severe depression & anxiety due to her recent life circumstances

Medical History Bipolar disorder Depression. 16 weeks pregnant

Medications: Valium 5-15mg PRN Seroquel 25 mg

Social History: Lives in share accommodation house with 3 other friends in Murwillumbah Parents live locally but no contact with them for the last 6 months. They are not aware of her pregnancy situation: She had been involved in a relationship for 10 months that

Current Admission 24/04/2017: Admitted to the young adult mental health ward at Robina Private Hospital with severe depression & anxiety due to unexpected pregnancy. Father of child not willing to recognise child as he already has a family. He ceased all contact after finding out about the pregnancy. She doesn’t want the baby upset she can’t afford abortion. States: “she wants to die”. Refuses to get out of bed, cries continuously and avoids any social contact. Reports weight loss of 10 kg over the last 2 months. Emotionally unstable, anxious about the pregnancy, current situation and the future.

Requires iron transfusion due to severe anemia malnutrition.           

Food & fluid 24hr supervision commenced

HOSPITALISATION  25/04/17-26/05/17

Ongoing treatment with psychiatrist & psychologist. Receives Transcranial Magnetic Stimulation (TMS) therapy for depression. Her mood is now stable, accepts the pregnancy and keeping the baby. 5KG weight gain with improved appetite. Still anxious about the near future after discharge. Still refuses to contact her family& inform them about her situation Discussed social worker help & requested referral

Discharge date planned: 30/05/2017

Discharge Plan: Social worker referral. Accommodation arrangements after discharge suitable for a baby. Discuss the importance of family support with pregnancy after labor

Assist her managing her financial situation & applying for financial support Referral to community social services for single mothers & community services GP regular appointments organised to check pregnancy and health status.

Writing Task: You are the nurse looking after Gemma Brown in the young adult mental health ward at Robina Private Hospital. Using the information provided, write a referral letter to the social worker in charge of the mental health ward, in Robina Private Hospital, 375 Stuart Street, Robina, QLD 4221 requesting assessment of Gemma’s situation and help with living arrangements after discharge.

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Sanithy Lionel OET letter

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TASK 55

You are a registered Nurse at Geriatric Assessment and Rehabilitation Unit MS Sanithy Lionel is a patient admitted in the ward where you are a Charge Nurse

Patient Details           Name  :Sanithy Lionel Age: 82 Years          

Family :Married, Lives with husband

2 daughters and 3 grandchildren live in the same area

Medical History: H/o DM diagnosed 2002 Metformin 850mg/day.   Osteoarthritis diagnosed 2005, Voltaren

Visits her GP regularly.         

Complaint with diet, medication and exercise regime

Recent Medical history 27/10/2017:               

Onset of tenderness, swelling and pain in R lower leg last night

R and L leg pain swelling itchy burning sensation both legs swollen and flaky.     Ulcer on R leg excdates

Rigor, last night.          Temp 37.7 , BP 132/82 RR32 HR 80.  Referred to Dr.Dean Mills Department Head

Geriatric Assessment and Rehabilitation Unit for urgent assessment

Diagnosis : cellulitis

28/10/2017                 

Started penicillin IV               

Paracetamol tab                      

Panadol for pain, inj lasix

Complaints of pain      Rigors, swelling stabled         

Itchiness decreased limited burning sensation

Cleaned ulcer dressing done

29/10/2017      Observations redness of eyes and swollen puffy face Wounds red less itchy

Still has burning sensation and edema No fever.       

Patient allergic to penicillin changed to ceplax IV

30/10/2017      No redness of eyes decreased face swelling and puffiness Ulcer clear fluids drained

Changed injce plax to tab cepalax, Tab peracetamol continued

01/11/2017                 

Fluids clear edema reduced itchiness reduced No fever or rigors

Dressing done by nurse Continued medications

Discharge Plan           Continue all medications as prescribed Monitor for side-effects.      Monitor L&R leg for further complications. Dressing should be done regularly by a practice nurse Report local GP if any complications. Include the referral letter from Head of Geriartric Assessment and Rehabilitation Unit, Dr.Dean Mills to her local family G.P.          Review in Out Patient Department after 5 days

Writing Task Using information in the case notes write a referral letter to the Practice Nurse at Newtown Medical Centre regarding MS Lionel, include present medical history and plan.

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Mrs. Anita Ramamurthy OET letter

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TASK 54:

Mrs. Anita Ramamurthy, a 59-year-old woman, is a patient in the (IPD) In-patient- department of a hospital in which you are charge nurse.                                     

Hospital          : Sydney Women’s Hospital

Patient Details          

Marital status            : Married        

Height : 5’4”   Weight            : 87 kg

BM1    : 33-Obese

Address for correspondence: #648, Bourke Street, Sydney

Admitted        : 18/06/2017  

Date of discharge      : 23/06/2017  

Diagnosis        : Acute appendicitis with appendicular lump

Treatment: Conservative management with IV antibiotics    (Planned for interval appendectomy in 6 weeks).

Social background    : Business woman (Education Consultant) – Hectic life, travels a lot due to work. Lives with her husband, Mr. Krishnan Ramamurthy, Two daughters both married. Elder daughter stays in India- about three hours away, works as an Entrepreneur; younger daughter in Canada, works as a dentist. Husband primary caregiver, elder daughter visits with husband once in a year, Scared of hospitalization, prone to anxiety related to this food of eating our, rarely cooks at home, sedentary lifestyle, complains of no time to exercise due to work, does not drink or smoke.

Diet:  Whole Milk, Ice-cream shakes, Fruit drinks, Doughnuts,Pancakes, Waffles, Pizzas, Cheeseburgers, Biscuits, muffins, Cajun Fries, Hash brown

Medical background: Known case of Essential Hypertension (2014) and Diabetes Mellitus type-2 (2010) (not compliant with diabetic medication)

Admission diagnosis: Complaints of pain in abdomen in right iliac fossa since 17/06/2017 Pain was sudden onset, acute in nature and was non-radiating fever (documented up to 101-degree F), aversion to food, evaluated outside where USG Abdomen revealed Acute Appendicitis, admitted for further evaluation and management.

Physical examination:  Conscious, oriented, No pallor, or icterus, No Clubbing, No Lymphadenopathy, no pedal Oedema BP: 126/84, Temp-afebrile, Pulse 72/tnin, RR 22/min SP 02 98%, CNS-NAD, Chest – Bilateral entry equal, No added sounds.

Nursing management and progress

18/06/2017: Abdomen CT (plain) 18/06/2017 – acute appendicitis with hypoclensearea in the region of base of appendix at its attachment with vacuum? Phlegtnonous collection.

Possibility of scaled perforation cannot be ruled out; total leucocyte count- 21,000/cumin. 1/V Fluids, broad spectrum antibiotics (Intipenem), PPI, Analgesics, antipyretics, other supportive treatment (6/6), Regular Blood Sugar Monitoring (6/6)

19/06/2017: TLC – 8,000/cumm; complaints of considerable pain in abdomen, headache, sips of water, extremely distressed, constipation, unable to pass gas.

20/06/2017: TLC-14,000/cumin; complaints of insomnia, headache, tenderness in abdomen, weakness, tolerating sips of coconut water and tea.

21/06/2017: TLC-11,000/cumin; tolerating soft diet, can ambulate with assistance, complains of weakness, Rev. Dietician re diabetic diet.

22/06/2017: TLC-8,000/enmm, able to ambulate slowly, independent with ADÇs.

23/06/2017: Pt. stable, accepting orally well, adequate urine output, TLC showing improving trend. Pt. stable, Rev. Endocrinologist – regular chart BSL, INJ Human Mixtard. Subcutaneously bd (12 hourly) 8 units (1 wk.) AC Breakfast and 6 units AC dinner.

Assessment    : Pt. stable with plan for interval appendectomy (6 weeks).

Medications TAB Ddlo (Paracetamol) 650 mg, t.i.d. (8 hrly) for 3 days then PRN. TAB Pantocid (Pantoprazole) 40 mg mane for 10 days.

Tab Tenorid 25 mg (Ateno 101) mane. Tab Supradyn (multivitamin) mane Tab Farobact 200 b.d.

Discharge Plan: Avoid strenuous activities/Travel. Advised to lose weight (exercise program to start after appendectomy). Normal Diabetic diet and low-fat diet – Pt. requests more information, esp. simple recipes that can be easily prepared at home. Monitoring of tinting and postprandial blood sugars (Present chart during Follow- up consultation). Follow up in OPD on 30/06/2017 at 3 PM. Husband advised to contact us immediately in case of persistent high grade Fever/pain (at 03492250); Pt. concerned re monitoring of blood glucose levels and insulin injections Husband requests home visit for demonstration

WRITING TASK 1:  Using the information given in the case notes, write a referral letter to Ms. Prabha, Shrishti Nursing Home Care Agency, Sydney, requesting a home visit to provide instructions on self-monitoring of blood glucose levels and administering insulin injections following Mrs. Ramamurthy discharge.

WRITING TASK 2: The patient has requested advice on simple recipes for low-fiat diabetic diet. Write a letter to Ms. April, Dietician, 258, George Street, Sydney on the patient’s behalf. Use the relevant case notes to explain Ms. Ramamurthy’s condition and information he needs. Include medical history, BMI, and lifestyle. Information should be sent to her home address.

WRITING TASK 3: Using the information provided in the case notes, write a letter detailing the post- discharge care required for the patient to the patients husband, Mr. Krishnan Ramamurthy, #648, Bourke Street, Sydney

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Jack Mills OET letter

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TASK 53: Today’s Date 21/06/15

You are a Mental Health Nurse at Spirit Hospital Psychiatric Emergency Care Centre (SHPECC) and Jack Mills is a patient on the ward.

Patient Details           Name – Jack Mills     

DOB    – 01/09/1993   Single

Admission      23/05/2015 (Spirit Hospital Psychiatric Emergency Care Centre)

Discharge       27/06/2015

Diagnosis        Schizophrenia, paranoid type

Symptom History Nov, 2014. Jack had the first serious psychosis triggered by his move to a university in Canberra He was hospitalised for 2 weeks & stabilised on Haldol 20 mg and sodium valproate 125 mg, daily.

Dec, 2014 He has lived with his mother at Parramatta (Sydney area) since dx and been attending day tx and a structured work program in Parramatta Spirit. Community Mental Health Service, NSW. His work attendance in the structured work program has been sporadic. He has occasionally attended client support meetings.

Feb 2015 Attempted suicide: A Possible stressor was that 1 week ago his mother informed him of ideas to remarry in the near future. Self-harm through deep cut on both wrists Hospitalised in ED, surgical tx, under 24hr supervision. Refused to change medication.

May, 2015 He has been increasingly isolated for the past 2 weeks, working on his computer and is very secretive about what he is doing. He stopped attending his work program, saying that he had “more important work” to do at home. His mother believes he stopped taking medications. Jack refuses to eat or talk with his mother; is nervous because of his mother’s plans to remarry and move to Manly (Sydney area) He was brought to Spirit Hospital Psychiatric Emergency Care Centre (SHPECC) by his mother on 23/05/15 He has been irritable, suspicious and stated that has been hearing multiple voices in his head for the past week.

Family History Jack’s parents separated 4 years ago and divorced 2 years agoJack’s father is a lawyer. Their relationship is pleasant but not close.Jack’s mother runs her own craft store and is agreeable to having Jack live with her. No other children in the family

Psychosocial History: Completed high school; above-average student; often involved in school and extracurricular activities. He smokes a pack of cigs a day and drinks beer, but there were binge drinking episodes.During college time. He denies any illicit drug use. He has a keen interest in computers and collected considerable equipment and software, primarily gifts from his father. He has been on Disability Support Pension (DSP) since 2012

Medical History        Nil

Hospital Progression: The patient’s sodium valproate was increased to 125 bd and then 250 tds

His need for intramuscular (IM) medication, or other medication was explained. The patient fiercely objected about injection, saying, “I am a reliable person, I can always take the medicine.” The fact is that he has not been very compliant. After much discussion, the patient has agreed to take 4 mg of Navane IM qid

Jack received one-to-one, supportive, and insight-oriented psychotherapy on various issues (importance of compliance, taking meds, and avoiding alcoholic beverages). His participation through the program was less than adequate as he could not concentrate and focus, but he still participated in psychotherapy group

Condition on Discharge  His sleep and concentration but judgment still impaired

Follow-up: The patient will be living with his mother at Manly and will be continued on medication (Sodium valproate 250 bd and pavane 1.5 mg 1M q.) 4 weeks. The next dose is due on July 17, 2015

One-to-one psychotherapy is needed. Advice to abstain from alcohol and give up smoking

Writing Task: Using the information in the case notes, write a letter to Jim Wood, the Mental Health Nurse at Manly Community Mental Health Service, Ipswich Rd, Manly, NSW, 2345.

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Mr. Luis Morgan OET letter

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TASK 52 You are the Registrar of the medical ward, Royal Adelaide Hospital. You are planning to discharge the following patient & to arrange follow-up visits with his GP at the place where the patient is living.

Patient’s Name           : Mr. Luis Morgan      Date of Birth  : 7th August, 1955

Social History:Indigenous clerk, ex-smoker until last year,until then smoked 10-15 cigarettes daily for 35 years

Past Medical History : Anterior myocardial infarction 2 years ago, coronary

angiogram       inoperable       coronary          artery   disease, Hypertension, Type 2 diabetes mellitus for 10 years.

Current Medication  : Glibenclamide 10 mg, Metformin 500 mg, but not compliant, reluctant to commence Insulin, Frusemide 40 mg, Aspirin 75 mg.

2 Jan, 2010 7:00 AM Subjective      : brought into emergency department by ambulance at 7 inthe morning, acutely breathless, looks extremely unwell, unable to speak, sitting up gasping for breath

Objective: mildly obese, cold, sweaty, cyanosis, pulse – weal, rapid & irregular, BP- 160/100 mm Hg, Jugular venous pressure- elevated to jaw, heart sounds- inaudible, Inspiratory crepitations, mild pitting ankle oedema.

Assessment: Congestive heart failure probably due to recurrent infraction.

Plan: immediate treatment (oxygen, 100 mg IV frusemide, 5mg IV morphine, glyceryl trinitrate 600 micrograms), urgent investigations (complete blood picture, electrolytes and cardiac enzymes) ECG, CXR insert urinary catheter.

2 Jan, 2010 7:30 AM: Subjective     : still acutely short of breath, all other symptoms – remain

Objective        : elevated glucose (18.3 mmol/L), elevated serum creatinine (0.19 mmol/L) ECG consistent with acute inferior infarction with atrial fibrillation, CXR – obvious cardiomegaly & pulmonary oedema

Assessment    : heart failure secondary to recurrent myocardial infarction

Plan: start IV isosorbide dintrate, oral digoxin, IV heparin, monitor intensively. Transfer to coronary care unit

3 Jan, 2010: Subjective         : improved considerably, now able to talk, admits unwell for 2 days, mild chest discomfort on the day before admission, was planning to see community doctor but became acutely short of breath, called ambulance.

Objective        : blood sugar level-well controlled all the signs significantly improved

Plan    :stop    nitrate  infusion,          continue          other    medication, Echocardiogram

14 Jan, 2010: Subjective       : has made gradual recovery, now ready to be discharged, can walk along the corridor for 15 minutes without breathlessness.

Objective        : heart – lungs – kidney’s functions – stable, Echocardiogram – moderately dilated left ventricle with mild mitral regurgitation, functional impairment – moderate.

Plan    : Change the current medication into oral forms (frusemide, aspirin, digoxin, warfarin, twice daily insulin), refer to his GP for regular follow-up visits and dosage adjustment.

Writing Task: Using the information in the case notes, write a letter of referral to Dr. Susan Wang, General Practitioner at the Family Care Clinic, 1009 Melbourne Street, North Adelaide, Sa 5006.

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Lisa Black OET letter     

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TASK 51 LISA’S CARPEL TUNNEL SYNDROME

Patient    : Lisa Black      

Aged   23        Occupation : Art Student

Address   : 6 Sutton Avenue, Seacombe Gardens, SA 5047

You are the Student Service Charge Nurse at Flinders University Medical Centre. The above patient has been seen a few times by Dr. Alex Chin, a GP at FUMC. You have been asked by Dr. Chin to write a referral letter in his name to Dr. Peter Brixton, a private neurologist to carry out a nerve conduction test. Dr Brixton practices at 24 Grenfell St, Kent Town, SA.

File Notes:     

Previous Visitations:             8/2/12, 14/4/12, 21/6/12, 10/12/12

HISTORY

First visit complained of weakness in R wrist and pain in palm area, Weakness when gripping a pen paint brush. Unable to open screw top bottles. Pt. appeared overweight and admitted being easily tired. Suggested giving hand a rest from painting activities. Prescribed Panadol tablets for one week

On second visit pt claimed that the hand had not improved and at night time gettin 8 pins and needles and tingling feeling after sleeping, was suggested she avoid sleeping on the right side.

Arranged X-ray of wrist as pt said she might have sprained it when falling down accidentally a few months ago. Prescribed bupofoem for one week.

On third visit X-ray was unremarkable but symptoms persisted. Pt advised that there might be possibility of carpel tunnel syndrome and to arrange neurologist for nerve conduction test on R hand. Suggested wait a few months to see if situation still the same before doing the test.

On last visit pt had not improved therefore agreed to refer her to a neurologist (for nerve conduction last. Suggested she spend more time walking outdoors and having exercise and avoid excessive use of a hand. Recommended vitamin supplements such as Glucosamine.

Write the referral letter on behalf of Dr. Chin who is away for the day. He will sign it tomorrow.

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Mr. Michael White OET letter    

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TASK 50  You are a nurse for a general practitioner and a patient is going to have a day colonoscopy procedure in the hospital next week. You are attending the patient for the first time

Patient Details           : Mr. Michael White                          

DOB    : 05.02.1956

Next of Kin     : Sister, Contact number: 05743863564        

Marital Status           : Single

Date of Birth  : 12 August 1956.     Presenting issue : colon cancer scan results: positive, pt wants colonoscopy

Social Background: Lives alone in a large house                

Full time worker         Hobbies          : cycling

Grandfather died of colon cancer (2005)                   

Father-bowerl cancer (1996): resection, other procedure

Medical Background

2013: Some bowel issues: constipation, Poor diet, overweight, eating fast food, drinking and smoking heavily

2014: Cold flu, runny nose not related to bowel/stomach problems)

2015: headaches, fever, tired (not related to bowel/ stomach problems)

On Doctors consultation: Patient admitted changing bowel patterns and bowel test results: abnormal Patient is worried about family history and wants colonoscopy. Pathology test requested. R/V post procedure doctor & nurse

Nursing Notes.          

RR: 22 hr; 77 BP: 145/85, Spo2:97 % RA                 Height: 175 cm, Weight: 80 kg

Pathology results : FBE, UED, REC (will receive preprocedure)           Avoid smoking and alcohol consumptions

Previous anesthetics: No issues, may not need that much amount of anesthetics

Nursing Notes                       

Arranged transport for day procedure

NKA, sensitive to codeine      : Alert band attached with this letter               : Alert to inform other staff

Patient signed the consent form          strictly fasting since midnight : a day before the procedure

Diet prep        : Have light breakfast the day before the procedure then thin fluids afterward.

Bowel preparation    : PREPKIT C 2 days prior to procedure

Brochure given          : Explained the procedure, possible outcomes and

risks associated with procedure, pre and post expectations, complications, side effects, risks of anesthetics, full sedative, local but not full block anesthetics Importance of balance diet and exercise explained

Follow-up                    R/V. Post procedure with doctor & nurse

Further counseling and tests will depend on the result of the surgery Send letter to a day procedure nurse

Using the information in the case notes, write a letter to the surgical Nurse., Georgia Surgical Hospital, 27 Station Road, Brisbane, including details of your preprocedure assessment and nursing management.

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Loving people

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