Occupational English Test – Writing (Nursing)

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

Notes:

Imagine that today is 26 June, 2024. The two-month old is being presented to his Pediatrician where you are his charge nurse.

Patient Information:

• Name: Ivan Rich.
• Age: 2 months.
• Mother: Sarah Rich. Father: David Rich.
• Hospital: Holy Angels’ Hospital, Pittsburgh, United States.

History:

• Birth History: Normal birth, all parameters within normal range.
• Duration of Illness: 1 month.
• Previous Hospitalizations: Once.

Previous Medical Visits:

22/05/2024

• Evaluated by Pediatrician.
• Concerns: Reduced feeding and mild fever.

Examination Findings:

• Temperature: 39°C.
• Heart Rate: 160 bpm
• Respiratory Rate: 50 breaths per minute
• Blood Pressure: 85/55 mmHg.
• General Appearance: Appears lethargic and irritable.
• Poor weight gain observed.

Systemic Examination:

• Tachycardia noted.
• Mild tachypnea, no retractions or wheezing.
• Signs of dehydration, reduced bowel sounds.
• Prolonged crying spells, irritability, normal tone and reflexes.

Investigations:

• WBC: 18,000 cells/µL (elevated).
• Hemoglobin: 10.5 g/dL (slightly low).
• Platelets: 450,000 cells/µL (elevated).
• C-Reactive Protein (CRP): 25 mg/L (elevated).
• Blood Culture: Pending.

Possible Diagnosis:

• Bacterial or Viral Infection.
• Acute Gastroenteritis.
• Dehydration.

Management Started (Patient admitted for three days).

• Immediate Treatment.
• IV fluids for rehydration and electrolyte correction.
• Antipyretics for fever management (e.g., acetaminophen).
• Anti-emetics and oral rehydration solution for vomiting and diarrhea.

24/06/2024

• Persistent high fever (39°C – 40°C) for the past week.
• Reduced feeding and lethargy.
• Episodes of vomiting and diarrhea.
• Failure to gain weight adequately.
• Increased irritability and prolonged crying spells.
• Managed with the same medicines prescribed previously. Patient admitted.

26/06/2024

• Being discharged today (conditionally).
• Referral back to Pediatrician Dr. Richards Aringrosa for continued care and monitoring (in three days).

Plan:

• Await results of blood and stool cultures.
• Repeat CBC and CRP in 48 hours.
• Monitor for any signs of deterioration, such as increased lethargy, persistent vomiting, or signs of severe dehydration.
• Ensure regular feeding and hydration.
• Educate parents on signs of dehydration and when to seek immediate medical attention.

Writing Task

Using the information in the case notes, write a letter to the District Nurse, to visit the patient daily to monitor progress and to help Ivan’s parents with, for example, medication administration, etc. Address your letter to Ms Angela Ferry, District Nurse, Mayor’s Ave., Pittsburgh 66.

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.