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OET Letter Case Notes

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OET Letter Case Notes


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      • Medium



      Ryan and Rohan

      Case note 3




      Read the case notes below and complete the writing task which follows.

      Ryan and Rohan are patients in a new-born ICU where you are the NICU charge nurse at Royal Woman’s Hospital, Sydney. Mother is already discharged and babies are yet to be discharged.

      Age                                       1 week old babies.
      Address                               1278 Over the Avenue
      Victoria, Sydney 0099
      Mother                                Mrs Angelina Mickle, DOB 19/10/1995
      Had gestational diabetes mellitus during antenatal period.
      Attended all antenatal visits.

      Father: Mickle Luke, 34 years, graphic designer.

      Other children                   Reyona Mickle, 2 years

      Medical History                 Mrs Mickle’s admission date – 08.01.2019;

      • Complained of foetal distress due to cord entanglement;
      • Caesarean section done at midnight, day of admission.

      Patient 1 Details – Ryan, 3 days, first baby

      • Aspirated meconium
      • ↓ HR, ↑ RR, bluish discoloration on upper and lower extremities;
      • Apgar 4/10, poor sucking O2 2L/hr
      • Weight: 2.5 kg
      • Fraternal twins (dizygotic)
      • Diagnosis confirmed through chest X-ray and blood gas test.
      • Medical progress – 17.01.19 Poor sucking.

      Nursing management   

      • Prophylactic antibiotic therapy,
      • Ampicillin 50 mg BD, Gentamycin 15 mg BD
      • Radiant warmer therapy
      • IV Fluid DNS
      • Oxygen therapy (via tent)
      • CPAP for 3 days after delivery

      Patient 2 Details – Rohan, 3 days, second baby

      • Weight: 2 kg at the time of birth
      • Poor sucking, Apgar 6/10, HR good, ↓RR
      • Both are expelled meconium.


      • Cleft lip and cleft palate;
      • Mother depressed.

      Nursing Management

      • IVF DNS therapy
      • Oxygen therapy (via tent)
      • Radiant warmer therapy to continue till he gains weight.

      General Discharge Plan

      • Roshan needs radiant warmer therapy;
      • Monitor sucking ability of both children;
      • Continue IVF therapy (both children);
      • Roshan needs paediatric surgical consultation.
      • Monitor their weight everyday;
      • Needs psychological support for their family especially for their mother.

      Writing Task

      Using the information given in the case notes, write a referral letter to MS Daniela Robertson, New-born Specialist Nurse, Sydney Children’s Hospital, Randwick NSW, Australia. Inform her of the current situation, medical background of the new born babies and requesting an immediate management for both babies.

      Biju John

      Love for English begins with understanding its unknown rules. Biju John lives on the internet, teaching OET, IELTS and PTE. More than a million students have thanked him from their heart.

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