\jOCCUPATIONAL ENGLISH TEST \WRITING SUB - TEST: NURSING \TIME ALLOWED: READING TIME: 5 MINUTES ‘WRITING TIME: 40 MINUTES gead the case notes below and complete the writing task which follows: you are a community-based nurse, A week ago, Mr. Barton's GP asked you to visit Mr. Barton at {home to monitor his symptoms, medications, diet and alcohol consumption. Today is your second visit and Mr. Barton tells you that heis moving toaruralare. Mr. Peter Barton 19/10/1956 (62 years old) 1 Simpson Drive, Noverton Medical History: Last 30 yrs: heavy alcohol consumption (10-12 standard drinks/day) Diagnosed in last 10 yrs: chronic hear failure, atrial fibrillation, cirthosis/chronic liver disease 5 vrs ago: paracentesis for abdominal ascites, currently conservative ‘management Medications: In medication blister pack: = Furosemide (Frusemide) 80mg b.d. = Spironlactone (Aldactone) 25mg b.d. = Lisinopril dinydrate (Apo-Lisinopril) 10mg daily = Digoxin (Lanoxin) 125meg dally = Thiamine (vitamin B1) 100mg daily Family background: 2 adult children (both live interstate, limited contact): older brother, younger sister live in rural town Social history: Divorced, lives alone, no contact with ex-wife Presenting complaint:. Recent exacerbation of abdominal ascites due to non-compliance with meds and continuing alcohol use Some shortness of breath (SOB) Pt feeling hopeless about health and future - says “no point taking meds”, “they do no good”‘Treatment record: 27/10/18 ‘Management: 03/11/18 Plan: (Nae Met Pt, not very interested in talking to me Inno acute distress, dyspnea on exertion and lying down HR 104bpm (Irregular rhythm), BP 110/86mmHg, RR 16rom Ht: 170cm; Wt 71.8kg Abdomen protuberant, slightly tender on palpation, no fluid wave Not taking meds as ordered - one or more doses each day still in blister pack, Pt says “can't be bothered” Little food in fridge. Pt says not eating much, not very hungry. Several empty wine bottles in house. Pt says “like a drink - so what!” Pt refused council meal delivery service Encouraged to eat more, drink les, take meds, low-sodium diet | mail listened/attempted to reassure. Pt seemed to hear/respond a tittle Little change, seems to be eating more (empty pizza boxes) Pt informed me of moving to Hilton rural town (his brother and sister lve there) - told GP it’s cheaper accommodation Refer to Hilton Community Health Centre nurse - phoned her today Request ongoing monitoring of meds, alcohol use, diet, symptom ‘management, give psychological support Ideally, Pt to visit nurse at health centre and have family support (ask to try to involve brother and sister) Less preferred: nurse visits at home regularly (or even very frequently, if necessary) If/when acceptable to Pt, refer to local council services (meal delivery, house cleaning) Using the information given in the case notes, write a letter of referral to the Community Nurse in Hilton. in your letter, briefly outline Mr. Barton’s history, current medications and the challenges for his care. Address your letter to Community Nurse, Hilton Community Health Centre, Main Street, Hilton, In your answer: ‘= Expand the relevant notes into complete sentences © Donot use note form © Use letter format aa 5 ‘The body of the letter should be approximately 180-200 words.