OET – All Case Notes & Corrected Letters

Mr Paul Ferris
Manager
Summerseat Nursing Home
Garden Street, Berry town

Dear Mr Ferris,

Re: [Missing]

Mrs Ellis is being referred to your facility for continued care and observation. She has been treated for renal colic associated with dilation of a collecting system and obstruction of the pelviureteric junction. Today, she is being discharged.

Mrs Ellis presented with abrupt onset of severe unilateral left loin and groin pain which radiated to the lower back. She was also dehydrated and unable to take oral fluids due to vomiting, sweating and restless. Her urine test and computerized tomography revealed the aforementioned diagnosis.

As part of Mrs Ellis’s management, fluids and medications were administered to alleviate her symptoms. The stone is expected to pass spontaneously within 1-2 weeks. To facilitate that, Tamsolucin, 8 mg and paracetamol have been commenced along with an increased amount of fluid intake(2-3 L daily). These need to be continued and their adherence need to be monitored to enhance her recovery process.

Given the above, it would be greatly appreciated if you could take over the management and render adequate care for Mrs Ellis’s betterment. Kindly observe her urine output and passage of stone which requires lab analysis. A dietician’s observation is essential to reduce intake of salt, oxalate-rich foods and animal protein foods. A list of diet details is enclosed with this letter. Of note, her follow-up appointment is scheduled on the 20th of this month.

Please contact me for more information about Mrs Ellis’s condition.

Yours sincerely,
Registered Nurse.

Mr Paul Ferris
Manager
Summerseat Nursing Home
Garden Street, Berry town

Dear Mr Ferris,

Re: Mrs Margo Ellis

Mrs Ellis[patient] is being referred to your facility for continued care and observation[purpose]. She has been treated for renal colic associated with dilation of a collecting system and obstruction of the pelviureteric junction. Today, she is being discharged[patient position].

Mrs Ellis presented with abrupt onset of severe unilateral left loin and groin pain which radiated to the lower back. She was also dehydrated and unable to take oral fluids due to vomiting, sweating and restlessness. Her urine test and CT revealed the aforementioned diagnosis.

As part of Mrs Ellis’s management, fluids and medications were administered to alleviate her symptoms. The stone is expected to pass spontaneously within 1-2 weeks. To facilitate that, Tamsolucin, 8 mg and Paracetamol have been commenced along with an increased amount of fluid intake (2-3 L daily). These need to be continued and their adherence need to be monitored to enhance her recovery process.

Given the above, it would be greatly appreciated if you could take over the management and render adequate care for Mrs Ellis’ betterment. Kindly observe her urine output and passage of stone which requires lab analysis. A dietician’s observation is essential to reduce intake of salt, oxalate-rich foods and animal protein foods. A list of diet details is enclosed with this letter. Of note, her follow-up appointment is scheduled for the 20th of this month.

Please contact me for more information about Mrs Ellis’s condition.

Yours sincerely,
Registered Nurse.

Re: Mrs Iris Lui, 94 years old

Mrs Lui is being discharged back into your care. She requires continuity of treatment and support for her ongoing difficulties.

Mrs Lui had been under our care for 2 months due to multiple illnesses related to her renal function. During her time in care, she was managed with intravenous fluids and antibiotics. Her blood culture tests were unremarkable.

Mrs Lui’s renal status has improved and her condition has stabilized; therefore, she is ready for discharge back into your facility.

In view of the above, kindly assist Mrs Lui with her daily hygiene and grooming. Please support her on ambulation with the use of her walking frame and stick. She should take her discharge medicines regularly as prescribed. Finally, she needs to come for follow up with Dr Lahood as scheduled.

Please do not hesitate to contact me, if you have any queries.

Yours faithfully,
Nurse

Re: Mrs Iris Lui, 94 years old

Mrs Lui is being discharged back into your care. She requires continuity of treatment and support for her ongoing difficulties.

Mrs Lui had been under our care for 2 months due to multiple illnesses related to her renal function. During her time in care, she was managed with intravenous fluids and antibiotics. Her blood culture tests were unremarkable.

Mrs Lui’s renal status has improved and her condition has stabilised; therefore, she is ready for discharge.

In view of the above, kindly assist Mrs Lui with her daily hygiene and grooming. Please support her on ambulation with the use of her walking frame and stick. She should take her discharge medicines regularly as prescribed. Finally, she needs to come for follow up with Dr Lahood as scheduled.

Please do not hesitate to contact me if you have any queries.

Yours faithfully,
Nurse

Ms Hamiltons mother in law
1292, Hamilton Arcade,
South Coast
Perth

Dear Ma,

Sub: Information regarding Care of Ms Hamilton

I write to advise you on necessary care to be given to your daughter in law as she is home after surgery.

Ms Hamilton was discharged a day ago and you are aware she was operated upon for delivery of her third child. As a caring mother-in-law u need her to remain fit, but I want you to understand it’s a gradual process, as the recovery period lasts for 6 weeks. During this time, she should be allowed to walk, move and exercise mildly as it will help in recovery there should be restrictions on car driving, lifting heavy things and performing tedious home duties. During this first week of discharge, a midwife contacted by the hospital will be visiting to check on health progress of mother and baby as well as remove stitches when due for removal. Wound site should be kept dry and clean always and encourage her to put on high-waisted cotton pants and loose clothing.

She should be allowed to take her drugs as prescribed as it doesn’t affect breast-milk or babys health, but in case she feels unwell like fever and extreme pain she should be allowed to take pain killer but not codeine or co-codamol. On getting out of bed, to reduce strain on the wound site she should be rolled to on her side to the edge of the bed, legs dropped on that side and gently lift her to sit on that side and do it the other way when she wants to get back on bed. U should notify the Gp / midwife incase of unusual feeling.

Do not hesitate to contact me for further information.

Yours faithfully
Nurse in Charge
Kings Wales’ mother and child Hospital

Mrs Hamilton
1292, Hamilton Arcade
South Coast
Perth

Dear Ma,

Sub: Information regarding Care of Mrs Hamilton

I am writing to advise you on necessary care to be given to your daughter-in-law as she is home after surgery.

Ms Hamilton was discharged a day ago and you are aware she was operated upon for delivery of her third child. As a caring mother-in-law you need to make her remain fit, but I would like you understand it’s a gradual process, as the recovery period lasts for 6 weeks. During this time, she should be allowed to walk, move and exercise mildly as it will help in recovery. There should be restrictions on car driving, lifting heavy things and performing tedious home duties. During this first week of discharge,a midwife contacted by the hospital will be visiting to check on health progress of the mother along with the baby and remove stitches when due for removal. Wound site should be always kept dry and clean and she should be encouraged to put on high-waist cotton pants and loose clothing.

She should be allowed to take her drugs as prescribed as it doesn’t affect breast-milk or baby’s health, but in case she feels unwell like fever and extreme pain, she should be allowed to take pain killer but not codeine or co-codamol. On getting out of bed, to reduce strain on the wound site she should be rolled to on her side to the edge of the bed, legs dropped on that side and gently lift her to sit on that side and do it the other way when she wants to get back on bed. You should notify the GP / midwife in case of unusual feeling.

Please do not hesitate to contact me for further information.

Yours faithfully
Nurse in Charge
Kings Wales’ mother and child Hospital