Case Notes 36.1 Julian Marco

Occupational English Test – Writing (Nursing)

Instructions:

• You have 45 minutes to write this letter.
• During the first 5 minutes, you should not pick the pencil.
• Start writing only when you are told.
• During the Reading Time, try to understand the case notes.

Melons Steps

• Mark (M) PPRRAADDDDDWK.
• Eliminate (E) irrelevant information.
• Launch (L) the letter with DADR.
• Open (O) the letter with PRPDD or PRPTT.
• Narrate (N) the remaining paragraphs using V or W.
• Sign (S) the letter with S/F.

Melons Errors

• Punctuation “Marks”.
• Follow “Expansion” Rules.
• Obey “Language” Rules.
• Have an “Order” (DADR, PRPDD, V/W, S/F)
• Do not change “Names”.
• Sex (Mr, Ms, Mrs, His, Her).

Details to Fill In:

• CANDIDATE NAME. ROLE NUMBER.
• DATE OF BIRTH. VENUE OF THE TEST. TEST DATE.

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

Notes:

Imagine that today’s date is January 8, 2024 and you are a community nurse from Sun District Health Community, visiting Mr Marco at his residence for the last 3 months.

Patient Details:

• Julian Marco.
• Age: 80 years
• 123 Maple Street, Sunnyvale, CA 94085.

Medical History:

• January 2021: Diagnosed with chronic arthritis. On Ibuprofen 400 mg PRN; Methotrexate 10 mg weekly.
• March 2021: Diagnosed with Alzheimer’s disease. On Donepezil 10 mg daily, Memantine 10 mg daily.
• June 2022: Diagnosed with cancer, underwent chemotherapy. Various chemotherapeutic agents as per oncology guidelines.
• July 2022: Catheter placed due to urinary retention.

February 15, 2023:

• Severe joint pain, swelling knees.
• Presented to GP at MMH, Sunnyvale.
• Diagnosis: Arthritis flare-up.
• ↑ Methotrexate 15 mg qw., Prednisone 10 mg q.d., for 2 weeks.

May 10, 2023:

• Memory loss, confusion.
• Second visit to GP at MMH.
• Progression of Alzheimer’s disease.
• ↑ Donepezil to 20 mg daily, added Rivastigmine 4.6 mg patch daily.

August 5, 2023:

• Difficulty urinating, pain in lower abdomen.
• Catheter blockage.
• Catheter replaced, prescribed Ciprofloxacin 500 mg twice daily for 7 days.
• Under the care of Nurses from Sun District Health Community.

November 20, 2023:

• Cut finger while preparing food, needed stitching.
• Dx Laceration.
• Wound cleaned and stitched, prescribed Amoxicillin 500 mg three times daily for 5 days

December 15, 2023:

• Increased confusion and agitation.
• Alzheimer’s disease exacerbation.
• Adjusted Memantine dosage to 20 mg daily, recommended behavioral therapy

January 5, 2024

• Patient fell at home, sprained ankle.
• Wife significantly concerned about his well-being, ability to manage at home.
• Provided supportive care for the sprain, advised rest, and prescribed Naproxen 250 mg twice daily.

January 8, 2024

• Fall and arthritis causing joint pain and limited mobility.
• Alzheimer’s disease affecting memory and cognitive functions.

Plan:

• 2 weeks of respite care in an aged care facility to ensure proper management.
• Provide relief to wife (primary caregiver).

Writing Task

Using the information in the case notes, write a letter to an aged care centre for respite care for the patient: Address the letter to the Manager, Sunshine Aged Care Home, 789 Elm Street, Sunnyvale, CA 94085.

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.

(You will find a sample letter on this letter here soon. Keep visiting).