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OET Official

Mrs. Carol Potter, a 70-year-old woman, presented with worsening left knee pain not relieved by medication. Examination found reduced range of motion and tenderness, and x-rays showed severe osteoarthritis. As her osteoarthritis has likely worsened and increased analgesics and physiotherapy have not provided relief, the nurse refers her to Dr. Waters for a surgical consultation to discuss potential knee replacement surgery.

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Nandhu King
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572 views3 pages

OET Official

Mrs. Carol Potter, a 70-year-old woman, presented with worsening left knee pain not relieved by medication. Examination found reduced range of motion and tenderness, and x-rays showed severe osteoarthritis. As her osteoarthritis has likely worsened and increased analgesics and physiotherapy have not provided relief, the nurse refers her to Dr. Waters for a surgical consultation to discuss potential knee replacement surgery.

Uploaded by

Nandhu King
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
  • Initial Patient Notes: Introduces the case details including patient information, medical history, medication, and family history.
  • Subsequent Treatment Record: Presents follow-up details with subjective observations, examination results, treatment plans, and test results.
  • Writing Task Instructions: Provides instructions for constructing a referral letter based on the given patient case notes.

WRITING: SUB – TEST: Nursing

TIME ALLOWED: READING TIME: 5 MINUTES

WRITING TIME: 40 MINUTES

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

Notes
You are a staff nurse at Stillwater Private Practice. You are examining a 70- year – old
woman who believes she has worsening arthritis

Patient details
Name: Mrs. Carol Potter

DOB: 30.12.1947

Address: 21 Gumtree Road Stillwater

Medical History
 2008 Osteoarthritis (OA) – mostly of hands & knees
 2015 Hypertension (HT) – well controlled
 2016 Skin cancer removed
 2016 Insomnia – 2 years, intermittent
Urinary tract infections (UTIs) – intermittent

Medications
 Ramipril 5mg daily
 Panadol Osteo (extended release paracetamol) 2 tablets t.d.s
 Temazepam 10mg noctep.r.n

Family history

 Mother – breast cancer

Social background
 Administrative assistant (retired)

Presenting complaint
 ↑ Pain in L knee with walking for last 12 months. Now quite severe – not relieved by
regular Panadol Osteo. Pain can even occur at rest after a long walk
Treatment record
23.02.18

Subjective
 No joint swelling/ redness
 No recent injury to knee
 R knee - some pain on walking, not nearly as bad as L knee

On examination
 Evidence of ↓ROM of L knee due to pain
 No swelling
 Tender to pressure along joint

Treatment
 Referral for X –ray of L knee, blood tests
 Review appointment to discuss results tomorrow
 Prescribe pain relief – naproxen 250mg b.d

24.02.2018

Test results

 X – ray: Evidence of severe OA in L knee - osteophytes and loss of joint space


Patella appears normal
No evidence of fractures
 Blood : FBE, UEC (normal)

Assessment
 Likely worsening OA

Treatment
 Arrange physiotherapy
 ↑ Analgesia
 Referral for surgical consultation - ? knee joint replacement

Writing Task
Using the information given in the case notes, write a letter of referral to Dr Waters, a
surgeon at Stillwater Private Hospital for a surgical consultation. Address the letter to Dr
Leigh Waters, Surgeon, Stillwater Private Hospital, 54 Main Street, Stillwater
In your answer:
 Expand on the relevant case 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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