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Day 17 Case Notes Analysis

This case notes will be used for writing today’s letters for correction. Before you proceed to writing this letter on the writing page, please read this case notes and answer the questions that below:

OCCUPATIONAL ENGLISH TEST

WRITING SUB-TEST: Nursing
READING TIME: 5 MINUTES | WRITING TIME: 40 MINUTES

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

NOTES

Name: Mr Christopher Fort
Age: 49 years
Married, lives with wife and 2 children
Admission date: 20/2/2020 (with chest pain, radiating to shoulder, difficulty breathing – 2 days along with generalized weakness, nausea , dizziness)
ECG – ST elevation
Ckmb+
Dx – Myocardial infarction

Medical History:

Peptic ulcer
Twice clipping done
Hypertension – 8 years, on tab Nicardia 5 mg once daily
Diabetic – 9 years, Human mixtrad Bd
Heavy drinker and smoker (10 years)
Eats oily foods, sugary creams
Nil exercise

Nursing Management and progress:

Height:173
Weight: 59
Temp: 98.6°F
Pulse: 72 b/m
Blood pressure:150/100 mm of hg

Medications

Pan 40 mg BD for one month
Aspirin 325 mg one month
Statix 40 mg of one month
Paraffin 10 mg of one month

Investigations Report:

RBS:190 mg/dl
FBS:118mg/dl
LDL:120mg/dl
HDL:40mg/dl
HB: 12

21/2/2020

Angiogram

Presence of clots in the left side of the coronary artery.
Percutaneous transluminal coronary angioplasty done.

Post-operative progress:

No complications. Blood pressure and blood sugar under control. Recommended by dietitian: Avoid oily foods and carbohydrates. Increase green leafy veggies, fruits and vegetables, fluid intake. He is ready to be discharged after the consultation with consultant.

Discharge plan:

Kindly schedule a follow up with Fbs, FLP, reports on 3/3/2020.

Medication monitoring

Quit-line programs
Blood pressure and blood sugar monitoring
Dietary management
Encourage daily Exercise
Follow up
Avoid strenuous exercise for two weeks.

Writing Task

Using the given information, write a letter to the district nurse requesting home visits to ensure medication compliance and dietary restrictions.

In your answer:

  • Expand the relevant notes into complete sentences
  • Do not use note form
  • Use letter format
  • The body of the letter should be approximately 180–200 words.

Now take this Case Notes Analysis and proceed to Letter Writing

  • Question of

    Who is the patient?

    • A pre-PTCA patient
    • A patient who needs advice on PTCA
    • A post PTCA patient
  • Question of

    Who is the recipient?

    • Doctor
    • District Nurse
    • Consultant
  • Question of

    What is the purpose?

    • Advice
    • Home Visits
    • Dietary instructions
  • Question of

    What is the admission / discharge status?

    • Discharged
    • Being discharged after consultation
    • Discharge not planned
  • Question of

    Is the patient known to the recipient?

    • Yes
    • No
  • Question of

    What is the least relevant information?

    • Medical History
    • Medicines
    • Social History

Written by 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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