englishmelon
Occupational English Test (Nursing)
Notes
This patient has been visiting his GP at City Hospital where you are his charge Nurse.
Patient Details:
- Name: William Carter
- Age: 59
- Occupation: Former Tennis Player
Medical History:
- Diagnosis: Age-related Macular Degeneration (AMD)
- Onset: Diagnosed 2 years ago
- Progression: Worsening over the past 6 months
- Symptoms: Blurred vision, difficulty recognizing faces, central vision loss
- Mental Health: Recent episodes of hearing voices
- Onset: Last 2 months
- Frequency: 3-4 times per week
- Duration: Lasts for a few minutes to an hour
- Description: Voices are usually indistinct, causing anxiety and confusion
Medications:
- Aflibercept (Eylea)
- Dosage: 2 mg intravitreal injection every 8 weeks
- Indication: AMD
- Olanzapine
- Dosage: 5 mg daily
- Indication: Hearing voices, potential psychotic episodes
23/07/2024 (Today)
- Vision: Further deterioration noted (by GP), with increased difficulty in daily activities
- Hearing: Continues to experience auditory hallucinations
- Mental State: Reports anxiety and distress due to the hallucinations
Family History:
- Father: Diagnosed with AMD at age 65
- Mother: History of depression
Social History:
- Lives alone
- Visits from a close friend twice a week
- Smoking: None
- Alcohol: Occasional (1-2 drinks per week)
Examination Findings:
- Vision: Visual acuity test shows significant central vision loss
- Mental Status: Appears anxious, no overt psychotic symptoms during the visit
- Physical Exam: Normal, no other abnormalities noted
Investigations:
- OCT (Optical Coherence Tomography): Shows progression of AMD
- Psychiatric Assessment: Recommended due to ongoing auditory hallucinations
Plan:
- Referral: To Ophthalmologist for further AMD management
- Referral: To Psychiatrist for assessment and management of auditory hallucinations
- Medication: Continue current medications, monitor for side effects
- Support: Referral to support services for daily living assistance and mental health support
Next Appointment:
- Follow-up: In 4 weeks for review of symptoms and treatment efficacy.
Writing Task
Using the patient’s history, write a letter of referral to Dr Risha Patel, Ophthalmologist, Central Eye Hospital, Sydney.
