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 polysomnography) 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/

VIEW ANSWEROET READINGOET SPEAKINGOET ROLE PLAYSOET LETTER WRITINGOET LISTENING

Would you like to download a copy of the practice test? Please click on the download button below:

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/

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.

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

VIEW MODEL ANSWEROET READINGOET SPEAKINGOET ROLE PLAYSOET LETTER WRITINGOET LISTENING

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.

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.

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

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.

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