OCCUPATIONAL ENGLISH TEST
WRITING SUB-TEST: NURSING
CASE NOTES: 1
TIME ALLOWED: Reading Time: 5 minutes (for 1 task)
Writing Time: 40 minutes (for 1 task)
Read the case notes below and compete the writing tasks (3 tasks)
which follows.
Notes:
Allison Watson, a 6-year-old, is a patient in the medical ward of which you are Charge Nurse.
Admitted after near drowning.
Hospital:
Weslmond Public Hospital, 22 High Street, Westmond
Patient details:
Name: Allison Walson
Age: 6 years
Next of skin: Marge Watson (mother)
Admission Date: 21 February 2016
Discharge Date: 3 March 2016
Diagnosis: Near drowning, potential hypoxic brain injury
Family: Lives with mother and father (Tim)
Medical history and medications:
Chicken pox (3yo)
Fractured collar bone (4yo)
Mild asthma
Social Background:
Primary school student (grade 1)
Enjoys sport (soccer, athletics)
Background:
Fell into fresh water lake while on fishing holiday with father.
Found 15-20 minutes later face down.
Paramedics arrived 10 minutes later, basic life support started.
On admission to ED: cyanotic
pulseless
apneic
fixed & dilated pupils
lympanic temp 27. 7 ͦC
Nursing Management and Progress:
21/2/16
CPR performed
Ventilator & endotracheal tubing inserted
Heated humidifier, radiant warmer, preheated blankets applied
Pediatric ventilator used
Initial ABG (Arterial Blood Gas) = 7.04/ 84/ 36/19/78%
Spontaneous circulation achieved
23/2/16
ABG=7.44/34/94/23/97%
BP 98/64
Tympanic temp. 34.8 ͦ C
Patient stable-transferred from ICU to general ward
25/2/16
Temperature normal
Unresponsive to command
Moving around the bed
No longer hyperventilated for ICP protection
Weaning off mechanical ventilation begun
29/2/16
Responsive to commands
Basic communication possible-slurred speech
Speech therapy commenced
Difficulty concentrating
Paracetamol 3x daily for headaches
Mechanical ventilation stopped
3/3/16
Communication improving still some slurring of speech.
Concentration improving cognitive function appears ok.
Neurological exams clear-need more tests to check for delayed problems as precaution.
Parents concerned about permanent speech and cognitive effects.
Paracetamol given when needed.
Occasional cough.
Ready for discharge.
Discharge plan:
Paracetamol for headaches
Monitor cough return to hospital ASAP if worsens
Speech therapy for speech
Neurologist for tests (neuropsychological, visual-spatial, IQ) in one week
GP to check cough, headaches
Parents to monitor cough, headaches, concentration.
Call Dr if minor issues, bring ER if severe.
Writing Task:
1. Write a letter to Dr Albert, Head Neurologist, Sydney Hospital, Sydney Request
Neurological examination.
2. Write a letter to GP to assess and monitor her cough, headaches and concentration.
Dr Mathew Jhon, Northern Medical Centre, NSW.
3. Write a letter detailing the post discharge care required for the patient to the patient
mother Mrs Marge Waston, 34 view Road NSW, 3004.
In your answer:
Expand the relevant notes in to complete sentences.
Do not use note form.
Use letter format.
The body of the letter should be approximately 180-200 words.
