Time Allowed: 40 Minutes: Nurses Writing Task 1

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Nurses Writing Task 1  

    

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

Time allowed: 40 minutes

Today's Date

25/07/09

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 2005 
Admitted:           15th July 2009
Discharged:  25th  July 2009
Country of birth: Sudan
Diagnosis:           Acute Meningoencephalitis

Social History

Parents:  Miri & Abdullah Obeki, refugees, arrived in Australia in 2008.


Employment:   Abdullah: Golden Circle pineapple factory, shift worker
Miri: housewife
Accomodation: 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


 Do not use note form
 The body of the letter should not be more than 200 words
 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

13/09/09

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 1991

Admitted: 9th September 2009

Discharged: 13th September 2009

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.

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 2009


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 12/09/08: 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


 Do not use note form
 The body of the letter should not be more than 200 words
 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

10/07/09

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: 29/01/1926

Marital Status: Widowed

Country of birth: Australia

Social History

Moved to Retirement Village following the death of husband in December


2007.

Next of kin: Son, Nicholas Olsen,


53 Palmer Street, Warwick 4370
Ph (07) 4693 6552.

Normal alert and orientated. Enjoys bridge, bingo and reading.

Medical History
Hypothyroidism since 1997
Hypertension since 2003
Glaucoma since 2004
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

16/05/09
Flu vaccination

29/06/09
Complaining of indigestion following evening meal. Settled with Mylanta

07/07/09
Unable to sleep – aches in shoulder. Settled following 2 Panadol and 1
Normison

09/07/09
Requested Mylanta for indigestion,Panadol for shoulder pain – slept poorly

10/07/09 am
Tired and feeling generally weak. BP 180/95. Confined to bed. GP called
and will visit 11/7/08 after surgery.

10/07/09 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:

 Expand the relevant case notes into complete sentences


 Do not use note form
 The body of the letter should not be more than 200 words
 Use correct letter format
Writing Task 4 Nurses

    

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

Time allowed: 40 minutes

Today's Date

01/08/09

Notes

You are Sarina Chai, a registered nurse at the Royal Brisbane and
Women’s Hospital (RBWH).   Maeve Greerson is a patient in your care.  
 
Patient Details

Name:   Maeve Greerson
Address:  Unit 6, 45 Walter St, Holland Park 4121
Phone:   (07) 3942 1658
Date of Birth:      9 October 1951
Country of birth: Australia

Social HistoryWidowed, no children.


Next of kin: Brian Hewson (brother) 67 Bridge Street, Toowoomba  Ph
(07) 4693 6558. 
Family and patient have requested no further treatments be used, other
than those necessary to maintain comfort and dignity and to relieve pain.

Medical History

March 2009:  Laparotomy.  Found to have cancer of the lower intestine


with wide spread metastases.  Partial bowel resection and colostomy
performed.
April 2009:  6 weeks radiation therapy for relief of symptoms.
Prognosis:  Not expected to survive more than 3 – 4 months.
24/07/09
Admitted to RBWH following collapse at home.  Dehydration, nausea,
severe pain
IV fluids commenced -   transdermal patch for pain, light low fibre foods
only.

25/07/09.
Nausea less severe – tolerating jelly, low fat yoghurt
Occasional break through pain – pain medication increased
Severe oedema of ankles and lower legs, bladder incontinence.
Does not feel she will recover sufficiently to leave hospital.  Requests visit
from Social Worker

28/07/09
Generally pain free, very weak and disorientated at times.  Rejecting
solids but able to tolerate fluids - requests apple juice and lemonade.
Social Worker contacted brother. Advises place available at Glen Haven
Hospice in Toowoomba from 1 August 2008.

01/08/09

Transferred via ambulance to Glen Haven Hospice

 
Writing Task

Using the information in the case notes, write a letter to the Director of
Nursing, Glen Haven Palliative Care Hospice, 971 Arthur Street,
Toowoomba, introducing this patient.  Using the relevant case notes, give
her background, medical history and treatment required. 

In your answer:

 Expand the relevant case notes into complete sentences


 Do not use note form
 The body of the letter should not be more than 200 words
 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

09/09/09

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 1956
Address 9476 Old Dam Road, Goondiwindi Q4390
Next of Kin Brother, Ernie O’Riley 72 Burke St, Cunnamulla Q4490

Admitted 2 September 2009


Diagnosis Obstructive coronary artery disease
Operation Coronary artery bipass grafts (x 4) on 4th September 2008

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
15/9/09
• 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


 Do not use note form
 The body of the letter should not be more than 200 words
 Use correct letter format
Task 6 Case Notes: Robyn Harwood

Time allowed: 40 minutes

Today’s date: 01/11/08

You are Sonya Matthews, a registered nurse at the Mater 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 1948

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 Mater 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: 30-10-2008
Date of discharge: 01-11-2008
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 19th November

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.


 Expand on the relevant case notes to explain his background and medical
history and the assistance requested.
 The letter should be 15-20 lines long.
 No more than the first 25 lines will be assessed.
Task 7 Case Notes

Time allowed: 40 minutes

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 Mater
Public Hospital. He was discharged from hospital on 17.3.08.

Name: Henry O’Keefe


Address: 12 Donaldson Street, Greenslopes 4121
Phone: (07) 3941 2267
Date of Birth: 2 February 1925
Admitted: 14.3.08
Diagnosis: Malignant Melanoma Left Shoulder

Medical History

Large lesion successfully removed 14.3.08.


Discharged 17.3.08
Needs assistance with showering and to dress wound prior to removal of
sutures at Mater Public Hospital on 24.3.08

Family History

Married aged pensioner. Lives in housing commission home with wife


Dorothy also an aged pensioner. No children
18.3.08.
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.

19.3.08

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.

 Do not use note form in the letter


 Expand the relevant case notes into full sentence
 Write between 180-200 words
Task 8 Case Notes

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

07/03/2010

Patient Details

Alison Cooper
Year 5 student
DOB: 14/6/2000
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


2010

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.

2009

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. 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.


 Expand the relevant case notes into full sentences.
 The body of the letter should not be more than 200 words.
 Use correct letter format.
Task 9 Case Notes

Time allowed: 40 minutes

Today’s date: 21/05/09


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 1936

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: 20-05-2009
Date of Discharge 22-05-2009 – 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 31-05-09

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. Expand on the relevant case notes to explain patient’s
background and medical history and the assistance requested. The letter
should be 15-20 lines long. No more than the first 25 lines will be
assessed.
Task 10 Case Notes
Time allowed: 40 minutes
Read the case notes below and complete the writing task which follows:
Today’s date: 9/7/08

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 1924
Admitted: 7 July 2008
Planned Discharge Date: 9 July 2008
Diagnosis: Left inguinal hernia

Medical History
Hypertension diagnosed 1998
Medication Atacand 4mg daily

Family History

Married 50 years to wife Olga DOB 8.2.32 – 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; expand the relevant case notes into
full sentences. The letter should be 15-20 lines long. No more than the
first 25 lines will be assessed.

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