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Writing Task-18

Mr Eusalyn Phelan, a 44-year-old clerk with a history of heart disease and diabetes, was admitted to the emergency department in respiratory distress. He was diagnosed with congestive heart failure likely due to a recurrent heart attack. After treatment, his condition gradually improved and he is now ready for discharge with oral medications and follow-up with his GP. A letter to the GP provides details of the hospitalization and recommends follow-up for medication management and monitoring given his ongoing heart and kidney conditions.

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Jigesh Joseph
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377 views2 pages

Writing Task-18

Mr Eusalyn Phelan, a 44-year-old clerk with a history of heart disease and diabetes, was admitted to the emergency department in respiratory distress. He was diagnosed with congestive heart failure likely due to a recurrent heart attack. After treatment, his condition gradually improved and he is now ready for discharge with oral medications and follow-up with his GP. A letter to the GP provides details of the hospitalization and recommends follow-up for medication management and monitoring given his ongoing heart and kidney conditions.

Uploaded by

Jigesh Joseph
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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OCCUPATIONAL ENGLISH TEST

WRITING SUB-TEST: NURSING

TIME ALLOWED: READING TIME: 5 MINUTES


WRITING TIME: 40 MINUTES

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

Name: Mr Eusalyn Phelan

DOB: 13 March 1976

Social history: Clerk ,ex-smoker until last year ,until then smoked 10-14
cigarettes daily for 25 years

Past medical history: Anterior myocardial infraction 3 years ago ,coronary angiogram
Hypertension ,type 2 diabets mellitus 13 years

Current medications: Metformin 500mg BD but not compliant reluctant to commence


Insulin, furesomide 40 mg ,Aspirin 75 mg

03 March 2011

Subjective: brought into Emergency Department in ambulance at 10.00 in the


morning, breathless, looks extremely unwell ,unable to speak
,sittig up ,gasping for breath

Objective: Mildly obese,cold ,sweaty ,cyanosed ,pulse weak ,rapid &irregular ,BP
-160/100mmHG. Jugular venous pressure elevated to jaw ,heart
Sounds- inaudible,inspiratory crepitations ,mild piting ankle edema

Assessment plan: ? congestive heart failure probably due to recurrent infraction


immediated treatment (oxygen 100mg IV fruoesmide 10 mg IV
morphine,glyceryl nitrate 600 micrograms) ,urgent
investiagtions(complete blood picture ,electrolytes and cardiac
enzymes)ECG, CXR, insert urinary catheter.

04 Mrach 2011
10.30 am

Subjective: still actually short of breath ,all other symptoms remain

Objective: elevated glucose (18 mmol) , elevated serum creatinine , consistent


with acute inferior infract with atrial fibrillation CXR- obvious
cardiomegaly &pulmonary edema

Assessment plan: heart failure secondary to recurrent myocardial infraction start IV


Isosorbride dinitrate ,oral digoxin ,IV heparin monitor intensively
,transfer to coronary unit

06 March 2011

Subjective chest: improved considerably , now able to talk ,admits -unwell for 2 days
,mild discomfort on the day before admsioin, was planning to see
community doctor but became acutely short of breath ,called
ambulance

Objective plan: blood sugar level – well-controled ,all the sign significantly improved
. stop nitrate infusion ,continue other medications . Echocardiogram
13 March 2011
Subjective:
Has made gradual recovery ,now ready to be discharged, can walk along
the corridor for 25 minutes without breathlessness

Objective; - heart , lungs ,kidneys functions- stable. Echocardiogram- moderately


dilated left ventricle with mild mitral regurgitation functional
impairment moderately
-Left ventricle with mild mitral regurgiattaion , functional
impairemment moderate

Plan: -change the current medications into oral forms furesmide ,aspirin
,digoxin,warfarin,twice daily insulin ,refer to his GP for regular follow-
up visits & dosage adjustment.

Writing task

Using the information on the case notes ,write a letter to his GP , Dr Steph Sandy ,General
Practitioner at the Phoenix care clinic ,Melbourne VIC 3876.

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