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5 Elbe Raggie Home Task

A 64-year-old man presented with a 3cm ulcer on his right foot. He has a history of diabetes for 15 years and smoked previously. Examination found prolonged capillary return time and some loss of sensation in his toes. The plan is to measure ankle brachial pressure ratios to check for arterial disease and perform ultrasonography to identify any arterial narrowing, with regular foot care also recommended. The task is to write a 180-200 word letter to the hospital requesting regular ulcer dressing and care for this patient.

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Samia Farooq
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75 views

5 Elbe Raggie Home Task

A 64-year-old man presented with a 3cm ulcer on his right foot. He has a history of diabetes for 15 years and smoked previously. Examination found prolonged capillary return time and some loss of sensation in his toes. The plan is to measure ankle brachial pressure ratios to check for arterial disease and perform ultrasonography to identify any arterial narrowing, with regular foot care also recommended. The task is to write a 180-200 word letter to the hospital requesting regular ulcer dressing and care for this patient.

Uploaded by

Samia Farooq
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Occupational English Testing

Writing Sub-test: Nursing

Time Allowed: Reading time 5 min

Writing time 40 min

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

Notes:

 A 64-years-old man presents with an ulcer on the dorsum of his right foot to the clinic
where you work as a community nurse.

Patient details:

Name: Elbe Reggie

DOB: 22/01/1956

Social & Medical & Family History

 Had an inguinal hernia repaired 2 years ago


 Stopped smoking on the advice of anesthetist.
 Previously he smoked 20 cigarettes a day.
 He drinks four pints of beer at weekend.
 His father died of a myocardial infarction aged 58 years.
 Diabetic on insulin for 15 years.

Medical Record:

3/09/2020:

 Pt noticed a sore area on the right foot 3 weeks ago and this has extended lesion which is
not painful.
 Pt complained of pain in the legs for some months.
 This pain comes on when he walks and settles down when he stops.

Examination:

 His blood pressure is 136/84mmHg.


 The respiratory, cardiovascular, and abdominal system are normal.
 There is a 3cm ulcerated area with a well-demarcated edge on the dorsum of the right
foot.
 The posterior tibial pulses are palpable on both feet, and the dorsalis pedis on the left.

 The capillary return time is 4 sec (prolonged).
 On neurological examination there is some loss of light touch sensation on the toes.
 Varicose veins are presents in the long saphenous distribution on both legs.

Plan:

 Further investigation would include measurement of the ankle: bronchial blood pressure
ratio.
 If this is less than 0.97 it suggests arterial disease, and a low index would be a
contraindication to pressure treatment in trying to heal the ulcer.
 Ultra sonic angiology would help to identify the anatomy of the arterial circulation in the
lower limbs and would show if there are correctable narrowing’s of major vessels.
 Care of the feet is a very important part of the treatment and should be regular element
of follow-up.

Writing Task:

 Use the information in the case note, write a letter to Ms. Aline Davies at Royal Perth
Hospital, 56 Churchill Ave, Subiaco WA, Australia, stating all the details about the
patient and requesting for regular ulcer dressing and care.

In your answer:

 Expend the relevant notes into complete sentences


 Do not use note form
 Use letter format

The body of the letter should be approximately 180-200 words.

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