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

 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

13/09/12

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

 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

10/07/12

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:

 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: 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

 DOB: 09/02/1951
 New resident of Dementia Specific Unit, Westside Aged Care Facility
 Single
 Under the Australian Guardianship and Administration Council protection

Medical History

 Ischemic heart disease (IHD) since 2005, takes Nitroglycerine patch, daily
 Stroke May 2011, after stroke - unsteady gait
 In 2011 - diagnosed with severe dementia - able to understand simple instructions only,
confused and disorientated
 Diabetes mellitus (type 2) since 2000 – on a diabetic diet
 Osteoarthritis of both knees 20 yrs. Voltaren Gel to both knees BD
 Weight gain 10 kg over the last 5 months, current weight 106kg (BMI of 30)
 Chronic constipation, takes Laxatives PRN
 No allergies to medication or food
 No teeth – has entire upper or lower dentures, sometimes refuses to wear dentures due to
confusion and disorientation
 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
 Lack of interests, but likes colouring and watching TV
 ↑emotional dependence on nursing staff
 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
o BP 120/70 mmHg
o RR – 22/min
o T– 37.1° C
o BSL – 6.0 mmol/L

1800 hrs

 No complaints
o Pulse – 88 BPM
o BP – 115/70 mmHg
o RR – 16/min
o T- 37.0 °C
o Skin: normal colour.
o 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

 Expand on the relevant case notes into complete sentences
 The body of the letter should be approximately 200 words long
 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

 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: 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

 Expand on the relevant case notes into complete sentences
 The body of the letter should be approximately 200 words long
 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.

 Do not use note form in the letter

 Expand the relevant case notes into full sentences
 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.

 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: 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
 Expand on the relevant case notes into complete sentences
 The body of the letter should be approximately 200 words long
 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

 Expand on the relevant case notes into complete sentences
 The body of the letter should be approximately 200 words long
 Use correct letter format