Nurses Writing Task

Nurses Writing Task 1 Read the case notes below and complete the writing task which follows Time allowed: 40 minutes Today's Date 25/07/12 Notes Vamuya Obeki was admitted through the Children's Emergency Department for acute meningoencephalitis as a result of a complication following mumps. Patient History Address: 32 Sexton St, Ekibin Phone: (07) 38485555 Date of Birth: 23 May 2008 Admitted: 15th July 2012 Gender: Male Discharged: 25th July 2012 Country of birth: Sudan Diagnosis: acute meningoencephalitis Social History Parents: Miri & Abdullah Obeki, refugees, arrived in Australia in 2011. Employment: Abdullah: Golden Circle pineapple factory, shift worker Miri: housewife Accommodation: Recently moved to rental accommodation GP: No family doctor Sibling: 2 year old brother, Saeed Language: Dinka, Arabic Interpreter needs: Abdullah understands spoken English but has limited written skills. Miri has limited understanding of English. Abdullah attends English classes. Medical History Parents state that both children had some kind of vaccination at birth but the vaccination record has been lost. Parents unaware of vaccine for Mumps. Discharge Plan Appears to have fully recovered from mumps and acute meningoencephalitis. Will need advice on recommended vaccines for both children. Will need neurological check-up. Writing Task

Using the information in the case notes, write a letter to The Director, Community Child Health Service, 41 Jones Street, Ekibin, requesting follow-up of this family. In your answer: 

Expand the relevant case notes into complete sentences

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Do not use note form

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The body of the letter should not be more than 200 words

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Use correct letter format

Writing Task 2 Nurses Read the case notes below and complete the writing task which follows. Time allowed: 40 minutes Today's Date 13/09/12 Notes Ms Nicole Smith is an 18 year old woman who has just given birth to her first child at the Spirit Mothers’ Hospital in Brisbane. You are the nurse looking after her. Patient Details Address: Flat 4, Matthews Street, West End 4101 Phone: (07) 3441 3257 Date of Birth: 4 September 1994 Admitted: 9th September 2012 Discharged: 13th September 2012 Marital Status: Single Country of birth: Australia Social Background Nicole is single and has had no contact with father of child for six months. She does not know his current address. No family members in Brisbane. Parents and sister live in Rockhampton. Does not currently have contact with them. Lives in a rental share flat with one other woman. Currently receives sole parent benefits. Feels very isolated and insecure. Doubts her ability to be a good mother and has talked about offering the baby for adoption. Medical History General health good Had appendicectomy at 15 years Non-smoker

No alcohol or illicit drug use. No drug or other allergies Obstetric History First pregnancy Attended for first antenatal visit at 16 weeks gestation. 8 antenatal visits in total. No antenatal complications. Birth details Presented to hospital at 1900hrs on 9th September Contracting 1:10mins 1st stage of labour: 16 hrs Mode of delivery: Emergency Caesarean Section Reason: Fetal distress and failure to progress. Baby Details DOB: 10th September 2012 Time: 1120hrs Sex: Male Weight: 4.4 kg Apgar Score: 6 at 1 min, 9 at 5 mins Resusitation: O2 only for few minutes Postnatal Progress Maternal post partum haemorrhage of 800mls Blood loss now minimal Wound: Clean and dry Haemoglobin on 12/09/12: 90 g/L Started on Fefol (Iron supplement) and Vitamin C Started breast feeding but not confident. Prefers to change to bottle feeding. Not confident in bathing and caring for baby Baby weight at discharge: 4.1 kg Feeding well No jaundice Writing Task Using the information in the case notes, write a letter to The Director, Community Child Health Service, 41 Vulture Street, West End, Brisbane 4101 requesting a home visit to provide advice and assistance for Nicole and her baby. In your answer: 

Expand the relevant case notes into complete sentences

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Do not use note form

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The body of the letter should not be more than 200 words

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Use correct letter format Writing Task 3 Nurses

Read the case notes below and complete the writing task which follows. Time allowed: 40 minutes Today's date 10/07/12 Notes Betty Olsen is a resident at the Golden Pond Retirement Village. She needs urgent admission to hospital. You are the night nurse looking after her. Patient Details Address: Golden Pond Retirement Village 83 Waterford Rd, Annerley, 4101 Phone: (07) 3441 3257 Date of Birth: 29/01/1929 Marital Status: Widowed Country of birth: Australia Social History Moved to a retirement village following the death of husband in December 2010. Next of kin: Son, Nicholas Olsen, 53 Palmer Street, Warwick 4370 Ph (07) 4693 6552. Retired triple certificate nurse - was the matron of a small country hospital for 15 years. Very aware of and interest in health issues. Likes to discuss and be kept fully informed of any changes to her medication or treatment. Normally alert and orientated. Enjoys bridge, bingo and reading. Medical History Hypothyroidism since 2000 Hypertension since 2006 Glaucoma since 2007 Allergic to penicillin

Prescription Medications Karvea 150mg 1 daily Oroxine 0.1mg 1 daily am Timoptol Eye Drops 0.5% 1drop each eye am & pm Normison 10 mg as required Non prescription Medication Golden Glow Glucosamine Tablet - 1 with breakfast for arthritis Vitamin C Complex Sustained Release – 1 with breakfast Mobility / Aids Independent with walking stick. Arthritis in hands. Wears glasses Continence: Requires continence pad Recent Nursing Notes 16/05/12 Flu vaccination 29/06/12 Complaining of indigestion following evening meal. Settled with Mylanta 07/07/12 Unable to sleep – aches in shoulder. Settled following 2 Panadol and 1 Normison 09/07/12 Requested Mylanta for indigestion,Panadol for shoulder pain – slept poorly 10/07/12 am Tired and feeling generally weak. BP 180/95. Confined to bed. GP called and will visit 11/7/12 after surgery. 10/07/12 pm Didn’t eat evening meal. Says felt slightly nauseous. Trouble sleeping, complaining of shoulder and neck pain. BP 175/95 Given 1 Normison 2 Panadol at 10pm Rechecked 10.45pm – Distressed, pale and sweaty, complaining of persistent chest pain, BP 190/100. Ambulance called and patient transferred. Writing Task Write a letter for the admitting doctor of the Spirit Hospital Emergency Department. Give the recent history of events and also the patient’s past medical history and condition. In your answer:

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Expand the relevant case notes into complete sentences

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Do not use note form

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The body of the letter should not be more than 200 words

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Use correct letter format Writing Task 4 Nurses: Nina Sharman

Time allowed: 40 minutes Read the case notes below and complete the writing task which follows: Today’s Date: 21/03/12 Patient Details 

Name: Ms. Nina Sharman

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DOB: 09/02/1951

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New resident of Dementia Specific Unit, Westside Aged Care Facility

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Single

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Under the Australian Guardianship and Administration Council protection

Medical History 

Ischemic heart disease (IHD) since 2005, takes Nitroglycerine patch, daily

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Stroke May 2011, after stroke - unsteady gait

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In 2011 - diagnosed with severe dementia - able to understand simple instructions only, confused and disorientated

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Diabetes mellitus (type 2) since 2000 – on a diabetic diet

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Osteoarthritis of both knees 20 yrs. Voltaren Gel to both knees BD

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Weight gain 10 kg over the last 5 months, current weight 106kg (BMI of 30)

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Chronic constipation, takes Laxatives PRN

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No allergies to medication or food

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No teeth – has entire upper or lower dentures, sometimes refuses to wear dentures due to confusion and disorientation

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Increased appetite– usually eats full portion of offered meals x 3 times daily and, also, goes into other residents’ rooms and eats their food as bananas, biscuits or lollies

Social History 

No friends

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Lack of interests, but likes colouring and watching TV

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↑emotional dependence on nursing staff

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Non-smoker, no use of alcohol or illegal drugs

Recent Nursing Notes 15/02/12 

Chest infection. Keflex 500mg QID x 7 days

26/02/12 

Occasional cough & episodes of SOB with ↑RR

27/02/12 

Sporadic throat clearing after eating yoghurt

20/03/12 1700 hrs 

Episode of choking on a piece of food (? food not chewed properly). She suddenly turned blue, grabbed the throat with both hands and coughed. The piece of solid food was removed.

1710 hrs 

Nursing assessment after treatment o

Pulse 110 BPM

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BP 120/70 mmHg

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RR – 22/min

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T– 37.1° C

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BSL – 6.0 mmol/L

1800 hrs 

No complaints

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Pulse – 88 BPM

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BP – 115/70 mmHg

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RR – 16/min

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T- 37.0 °C

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Skin: normal colour.

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Hospital visit not required

WRITING TASK You are a Registered Nurse at the Dementia Specific Unit. Using the information in the case notes, write a letter to Dietician, at Department of Nutrition and Dietetics, Spirit Hospital, Prayertown, NSW 2175. In your letter explain relevant social and medical histories and request the dietician to visit and assess Ms. Sharman’s swallowing function and nutritional status urgently due to a high risk of aspiration. 

Do not use note form in the letter

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Expand on the relevant case notes into complete sentences

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The body of the letter should be approximately 200 words long

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Use correct letter format

Writing Task 5 Nurses Read the case notes below and complete the writing task which follows. Time allowed: 40 minutes Today's Date 09/09/12 Notes

You are Lee Wong a registered nurse in the Coronary Care Unit, St Andrews Hospital Brisbane. Bill O’Riley is a patient in your care. Patient Details Name: Bill O’Riley DOB 12 January 1959 Address 9476 Old Dam Road, Goondiwindi QLD 4390 Next of Kin Brother, Ernie O’Riley 72 Burke St, Cunnamulla QLD 4490 Admitted 2 September 2012 Diagnosis Obstructive coronary artery disease Operation Coronary artery bipass grafts (x 4) on 4th September 2011 Social History • Never married • Lives alone in own home just outside Goondiwindi • Fencing contractor Medical History • Smokes 20 cigarettes/day • Alcohol: 2 x 300ml bottles beer / day • Ht 170cm Wt 99kg • Usual diet: sausages, deep fried chips, eggs, MacDonalds • Allergic reaction to nuts Nursing Management and Progress • Routine post operative recovery • Advised to cease smoking, reduce alcohol • Low fat diet • Walking well • Wounds healing well • Routine visit from Social Worker Discharge Plan • Returning Home to Goondiwindi • Appointment made for follow up visit to local GP Dr. Avril Jensen 2pm 15/9/12 • Local physiotherapist to continue rehabilitation exercise program Writing Task Mr. O’Riley has requested advice on low fat dietary guidelines and healthy simple recipes. Write a letter to the Community Information Section of the Heart Foundation, Gregory Terrace, Brisbane on the patient's behalf. Use the relevant case notes to explain Mr. O’Riley’s situation and the information he needs. Include Medical History, Body Mass Index and lifestyle. Information should be sent to his home address. In your answer: 

Expand the relevant case notes into complete sentences

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Do not use note form

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The body of the letter should not be more than 200 words

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Use correct letter format

Task 6 Case Notes: Robyn Harwood Time allowed: 40 minutes Today’s date: 12/07/11 You are Sonya Matthews, a registered nurse at the Spirit Hospital. Robyn Harwood is a patient in your care. Read the case notes below and complete the writing task which follows. Patient Details Name: Robyn Harwood Address: 8 Peach St, New Farm

Phone: (07) 3397 2695 Date of Birth: 4 February 1950 Social Background Marital status: Widow. No children. Lives alone Next of kin: Megan Mack (Niece) Niece lives with husband in Sydney who works as software engineer for Google Australia. Sister died recently. No other relatives. Medical History Diabetes Mellitus Type 2 Metformin 500mg mane Diagnosis Right partial rotator cuff tear Presented to Spirit hospital with pain and weakness in the right shoulder, especially when lifting arm overhead. Descending stairs at home and slipped, falling onto outstretched arm. Xray and MRI showed a partial rotator cuff tear. Orthopaedic surgeon discussed surgery. Patient prefers to try non-surgical treatment. Date of admission: 30-06-2011 Date of discharge: 12-07-2011 Treatment Ibuprofen orally QID Cortisone injections Daily physiotherapy Nursing Care Needs Needs blood glucose level monitoring 4 hourly May be elevated because of cortisone Needs assistance with shower and housework Orthopaedic review on 01/08/11 WRITING TASK Using the information in the case notes, write a letter to the Nursing Director Ms. Jenny Attard of the Community Home Care Agency, requesting visits from the home care nurse. In your letter: 

Do not use note form in the letter

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Expand on the relevant case notes into complete sentences

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The body of the letter should be approximately 200 words long

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Use correct letter format

Task 7 Case Notes: Henry O'Keefe Time allowed: 40 minutes Today's Date 19/3/12 Read the case notes below and complete the writing task which follows: You are a nurse with the Blue Skies Home Nursing Centre. You visited this patient at home today for the first time following a referral from the Spirit Public Hospital. He was discharged from hospital on 17/03/12. Name: Henry O’Keefe

Address: 12 Donaldson Street, Greenslopes 4121 Phone: (07) 3941 2267 Date of Birth: 2 February 1929 Admitted: 14/3/12 Diagnosis: Malignant Melanoma Left Shoulder Medical History Large lesion successfully removed 14/3/12 Discharged 17/3/12 Needs assistance with showering and to dress wound prior to removal of sutures at Mater Public Hospital on 24/3/12 Family History Married aged pensioner. Lives in housing commission home with wife Dorothy also an aged pensioner. No children 18/3/12 1st Home visit Showered patient. Wound dressed – healing satisfactory no sign of infection Balance a little shaky - complaining of increased arthritic pains in hands and legs. Currently taking Glucosamine & Chondroitin Supplement recommended by GP. Pain relieved with 2 Panadol 3 times daily. Confused about why he had operation. Dorothy concerned about future. Tells you she will be 83 in August. Says Henry has not been himself since the surgery. Keeps forgetting things. She finds it difficult to manage the house and garden. Neighbours are helping with shopping. Kitchen and bathroom disordered - trouble finding clean towels – dishes piled in sink, bed unmade. 19/3/12 Henry showered and wound dressed. Still a little unbalanced. Rests most of the day. Does not remember being showered yesterday. House still disorganised, washing piled up in bathroom. Dorothy says she would be lost without help from neighbours who also appear to be cooking meals for the couple. Concerns: Provided there are not complications with the wound healing, your role in providing nursing care ends when sutures are removed on 24 March. You consider that Jim and Dorothy need to be assessed for further on-going assistance in managing the house and garden and with shopping and the preparation of cooking. Plan: Request a home visit by the Aged Care Assessment Team as soon as possible to fully assess their needs and to arrange for appropriate further assistance to be provided. WRITING TASK Using the information in the case notes, write a letter to The Director, Aged Care Assessment Team, Brisbane South Region, 78 Masterson St. Acacia Ridge, Brisbane 4110. Explain why you are writing and what types of assistance may be required.

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Do not use note form in the letter

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Expand the relevant case notes into full sentences

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Write between 180-200 words

Task 8 Case Notes: Alison Cooper Read the case notes below and complete the writing task which follows. Time allowed: 40 minutes You are the school nurse at a Toohey Point Primary State School

Today’s Date 07/03/2012 Patient Details Alison Cooper Year 5 student DOB: 14/6/2002 Height:138cm Weight:40 kg Overweight for her age Eczema outbreaks on hands and mild asthma – has ventolin inhaler No other significant illnesses Youngest in her class Social History Father died in motor accident 18 months ago. Lives with mother, a bank manager, working full time Middle child- brother, Simon, aged 7 and sister, Lisa, aged 12 Paternal grandmother lives near school - provides after school and holiday care looks after children if unwell School Medical Record Regular absences from school dating back to time of father’s death Year 2: 3 days Year 3: 4 days Year 4: 10 days Year 5: 8 days in first term School Health Centre Records 2012 February 8: Complained of headache. Gave paracetemol, rested and returned to class. Noted eczema on hands red and weepy - has ointment at home. February 16: Complained of stomach ache. Called grandmother for pick up. February 22: Complained of aching legs. Called grandmother for pick up. March 4: Complained of headache. Gave parcetemol, rested 1 hour, still had headache. Called grandmother for pickup. March 6: Feeling nauseous - eczema on hands red and weepy. Called grandmother for pick up. 2011 February 15: Complained of toothache. Called grandmother for pick up. April 4: Complained of headache. Gave paracetemol - rested 1 hour. May 14: Headache, eczema on hands red and weepy, rested 1 hour not better called grandmother for pick up. July 25: Feeling nauseous. Called grandmother for pick up. August 16: Slight fever. Called grandmother for pick-up. September 22: Feeling unwell. Eczema irritating. Called grandmother for pick up. October 23: Complained of stomach ache. Rested 1 hour, returned to class.

November 27: Complained of headache. Gave paracetemol, rested 30 minutes. Social History Alison started school well but since Grade 3 has had trouble concentrating rarely participates in class activities unless encouraged. Avoids sporting activities – standard of her school work is declining. Has few friends and is often teased by her classmates about eczema & weight. Embarrassed about hands which don’t seem to be responding well to ointment suggested by chemist. Mother was contacted by class teacher regarding these issues. Says Alison is also becoming withdrawn at home. Alison was very close to her father – often talks to her about him and cries because she misses him. Seeks comfort in food like chips and cakes after school. Plan Refer her to the school psychologist to find out whether Alison has underlying grief related or other psychological problems. WRITING TASK Using the information in the case notes, write a letter to refer this girl to the school psychologist, Barnaby Webster, to assess her. Outline the purpose of the referral. Provide details of significant factors which will assist the psychologist to make this assessment. In your answer: 

Do not use note form.

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Expand the relevant case notes into full sentences.

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The body of the letter should not be more than 200 words.

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Use correct letter format.

Task 9 Case Notes: Annette MacNamara Time allowed: 40 minutes Today’s date: 21/05/12

You are Grace Jones, a qualified nursing sister working in Ward C25, Princess Alexandra Hospital. Contact Ph. 07 3897 7642. Annette MacNamara is a patient in your care. Read the case notes below and complete the writing task which follows. Name: Annette MacNamara Address: Unit 15, 86 Smart St, West End Phone: (07) 3379 5926 Date of Birth: 14 June 1939 Social Background Single Age Pensioner - Recently moved to a small flat in new suburb. House she rented for 10 years was sold. Feels increasingly lonely and isolated - rarely sees neighbours – transport problems make it impossible to continue to attend bowls and bridge clubs. Next to kin, Niece – Stella Attois Ph 075 5984 7216 lives and works in Southport - generally visits once a fortnight. Medical History Date of admission: 20-05-2012 Date of Discharge 22-05-2012 – provided no complications and home assistance arranged. Admitted to hospital following fall. Slipped and fell while descending stairs to put out garbage. X-ray revealed fractured right wrist – Laceration to left hand caused by broken glass. Stitches required- Severe bruising of right shoulder and lower back. Medications Karvea 150mg daily am – history of high blood pressure now controlled Normison 10mg-1 nightly for insomnia when required. Pain relief – 2 Panadol 4 hourly while pain persists. Discharge plan Organise daily visits from Blue Nursing Service to assist with showering and to dress hand wound. Social Worker to organise Meals on Wheels and physiotherapy. (niece will visit at weekend to help with housework and shopping) Stitches to be removed and situation to be reviewed at Out Patient Department appointment - 10.30 am 31-05-12

WRITING TASK Using the information in the case notes, write a letter to the Director, Blue Nursing Service, 207 Sydney Street, West End. 

Do not use note form in the letter

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Expand on the relevant case notes into complete sentences

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The body of the letter should be approximately 200 words long

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Use correct letter format

Task 10 Case Notes: Jim Middleton Time allowed: 40 minutes

Read the case notes below and complete the writing task which follows: Today’s date: 9/7/12 Patient Details Jim Middleton aged 84 was admitted to your ward following surgery for a left inguinal hernia. His doctor has advised he can be discharged within 48hrs if there are no complications following the surgery. Jim reports some pain on movement but has recovered well from the surgery and is keen to return home. Name: Jim Middleton Date of Birth: 3 July 1928 Admitted: 7 July 2012 Planned Discharge Date: 9 July 2012 Diagnosis: Left inguinal hernia Medical History Hypertension diagnosed 2002 Medication Atacand 4mg daily Family History Married 50 years to wife Olga DOB 8/2/36 – one son living in USA Jim is Second World War veteran – served two years in Borneo –Prison of War 16 months. Own their own home with large garden which they maintain without assistance. Very independent and proud that they have never applied for a pension or home assistance. Have always managed quite well on their income from a number of investments. Olga told you she is worried as income from these investments has recently been significantly reduced due to severe stock market falls. She is concerned Jim will not be able to continue to maintain their garden and they will not be able to afford a gardener or any other help at this time. Transport is also a problem as Olga does not drive. Not close to any reliable public transport so will have to rely on taxis. Olga thinks they may now be eligible to receive a pension and other assistance from the Department of Veteran Affairs but doesn’t know how to find out - doesn’t want to worry Jim. Olga is in good general health but becoming increasingly deaf - finds phone conversations difficult. She would appreciate a home visit. You agree to enquire on her behalf. Their address is 22 Alexander Street, Belmont, Brisbane 4153 Phone (O7) 6946 5173 Discharge Plan • Must avoid any heavy lifting • Should not drive for at least six weeks • Light exercise only • May take 2 Panadol six hourly for pain • Appointment made to see surgeon for post operation check at 10am on 11 August • Contact Department of Veterans Affairs re eligibility for pension and home help WRITING TASK

Using the information in the case notes, write a letter to The Director, Department of Veterans Affairs, GPO Box 777 Brisbane 4001. In your letter, explain why you are writing and the assistance they are seeking. 

Do not use note form in the letter

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Expand on the relevant case notes into complete sentences

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The body of the letter should be approximately 200 words long

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Use correct letter format