READ THE CASE NOTES AND COMPLETE THE WRITING TASK BELOW
You are Sara Hilton, a registered nurse at James Hospital. Mrs Sandy Kiran is a patient in your care.
Time Allowed:
Reading Time: 5 minutes
Writing Time: 40 minutes
Today’s Date:17/06/19
Patient Details
Name: Mrs Sandy Kiran
Address: 5 Peter, St, New Velly
Phone: (06) 1512 6348
Date of Birth: 10 March 1981
Social Background
Marital status: Widow. 2 children. Lives alone
Next of kin: Mari Smith (Niece)
Mari lives with husband in Germany who works as a mechanical engineer. Brother died recently. No other
relatives.
Medical History: Diabetes Mellitus Type 2-2010, hypertension 2015
Metformin 500mg mane, Amlodipine 5mg bd
Diagnosis:
Right partial rotator cuff tear
Presented to James Hospital with pain and weakness in the right shoulder, especially when lifting the arm overhead. Descending stairs at home and slipped, falling onto an outstretched arm.
X-ray showed a partial rotator cuff tear.
The orthopedic surgeon discussed surgery. The patient prefers to try medications first.
Date of admission: 28-05-2019
Date of discharge: 17-06-2019
Treatment– Paracetamol orally QID, Cortisone injections
Daily physiotherapy
OT review for home adjustment
Nursing Care Needs
ADLs, showering, dressing of a wound and personal hygiene, Needs blood glucose level monitoring 4 hourly. May be elevated because of cortisone
Orthopedic review on 01/07/19
Writing Task
Using the information in the case notes, write a letter to the Nursing Director Ms.Linda Binding of the Red Care Agency, requesting visits from the home care nurse.
In your answer:
Expand the relevant case notes into complete sentences
Do not use note form
The body of the letter should be approximately 180~200 words
Use correct letter format