Indefinite Articles: - Fast Track IELTS



OET 2.0 WRITING LESSON: REVIEW DURING THIS LESSONLearned what is required in the OET Writing exam and how the test is pleted exercises to understand what is required to be successful in the pleted activities to understand case notes present throughout the test.Reviewed OET sample questions to understand question types.Set homework for next week/arranged future lessons.REVIEWThe OET writing exam requires for you to write a short (180-200 words) letter regarding a patient. You are expected to clearly explain the type of letter that you are writing (referral, discharge, information, transfer etc,.) and to clearly relay the information to the professional or organisation you are writing to depending on the case notes that are provided.HOW THE EXAM IS GRADEDCandidates are assessed against the following criteria: Overall task fulfilment This means have you understood the task and its requirements. If the task asks for a referral letter, have you written a referral letter by mistake?Appropriateness of languageIs the language that you use formal or informal? Are you providing the relevant information?Comprehension of stimulusHave you understood the patient’s medical history? Are you able to explain it clearly in your letter?Linguistic featuresDoes your letter have good grammar and does one point naturally flow to the next?Presentation features (spelling, punctuation and layout)Should any marks be deducted for mistakes in spelling or punctuation? Is your letter formatted professionally?The Writing sub-test is scored by experienced assessors who receive ongoing training, monitoring and feedback on their performance after each administration of the test. Assessors give a score from A-F for each of the five criteria listed on the previous page, using a detailed set of level descriptors to guide their decisions. A score of A is the highest for each criterion. The five criteria are equally weighted in the scoring and analysis process.ACTIVITY 1Now read through the practice letter below.Nursing Unit Manager The Rehabilitation CentreSmithvilleWaterford9 February 2014 Hello sir, Re: Mrs. Bery Casey (DOB: 21 November, 1941) Mrs casey (Widowed recently), who was been treated for a fractured her left neck of femur, as she fainted and fell to the floor, is being discharged tomorrow. Therefore she is being referred to you for following up care. Mrs casey - lives alone - was found by her son who lives close to her home 2 hours later and admitted to our hospital on 4 February, 2014. Mrs casey had a left hemiarthroplasty and closed with staples and 2 exudrain tubes. After the operation, she has completed the intravenous antibiotics, also the drain tubes and alternate staples has removed. In addition, her pain has controlled by medication and her blood pressure has remained by Ramipril 5 mg (previously used 10 mg). Furthermore, she is able to walk with a pick-up frame and an assistant person, although she needs full assistance with her ADL.It would be greatly appreciated if you could continue maintaining her medication and monitoring her blood pressure. Also, please assess for her rehabilitation therapy. In addition, she will require to check her hemoglobin levels on 11/2/14 and remove remaining staple on 13/2/14. Finally, a hospital transport has arranged for 11 o’clock tomorrow morning. If you need further question, please do not hesitate to contact me. Kind regardsMary KhanConsider any improvements you would offer to this letter and now look at the examiner’s notes below. Fill in the missing words as part of the examiner’s comments. Find answers to this activity at the end of the workbook. Comments on scores Overall Task Fulfilment The candidate has shown the ability to manage the task and organise the information in a logical way. For example, the background information is (1) _____ together in paragraph 3, and the remaining actions relating to the discharge plan follow in paragraph 4 and 5. However, significant grammar errors and inaccuracies have a negative effect on the target reader in places. There are also further problems with (2) ____ such as ‘who was been treated for a…’Appropriateness of LanguageThe candidate has chosen lexis, register and tone which are generally appropriate for the target reader and the communicative task (e.g. ‘needs full assistance with her ADL’, ‘It would be greatly appreciated if you could continue monitoring her blood pressure’). A few inaccuracies (e.g. ‘following up care’) do not impede communication. As a whole, the letter is (3) _____ well, in that the reader can see an underlying sense of coherence to the way it is arranged and ordered. Comprehension of Stimulus The candidate demonstrates an understanding of the task and input which is generally accurate. Many of the main points (including the completion of the post-operative IV therapy and the need for a (4) ________ check) are explained clearly and given an appropriate degree of prominence. However, important elements of the (5) ________ (e.g. the paracetamol and the anti-embolic stockings) have not been covered and the target reader is not fully informed in those respects.Control of Linguistic Features (Grammar and Cohesion) The candidate has used a range of devices to connect information appropriate, including relative clauses, concessive clauses, and time phrases (e.g. ‘Mrs Casey, who has been treated...’, ‘...although she needs full assistance...’, ‘After the operation, ...’). However, inaccurate use and/or avoidance of passive structures impedes meaning at a number of points (e.g. ‘her blood pressure has remained by Ramipril 5mg’, ‘she will require to check her haemoglobin levels...’). (6) ________ sentences are attempted, frequently without success (e.g. ‘Mrs. Casey – lives alone – was found by her son who lives close to her home 2 hours later and admitted to our hospital...’). Control of Presentation Features (Spelling, Punctuation and Layout) The candidate has chosen an appropriate layout for the letter and spelling is accurate throughout. Lack of control of punctuation in the second paragraph (inappropriate hyphens and missing comma) make it necessary for the reader to re-read in order to retrieve the information. The patient also regularly forgets to put a (7) ________ at the start of the patient’s name.Now guess the scores (A-F) for this candidate and fill in the boxes below with your estimated score for this assignment…ScoresOverall Task…Approp. Lang…Compre. Stim…Linguistic…Presentation…ACTIVITY 2Read through the paragraph below and fill in the missing words using the words provided in the box. The text discusses tips to consider when writing your letters. Some answers are not required. layout and punctuation word count laid out missing mistakes problems accepted same proof-read formatting grammar deductedTake care of spelling– Spelling, along with _________ are the main aspects included under presentation features (one of the criteria under which assessment is done). When you are writing, take care of spelling, because any will be taken account of in your presentation features scores.Write within the writing limits-?Your marks will not be _______ if your write over or under the ________ (180-200 words). However, if you write more than 200 words, you will not get time to ______ your letter. Always spare some time at the end to proofread your letter for any _______ .Use accepted layout: – A number of layouts and letter formats are ______ by health professionals in different contexts. It is important that your letter is clearly ______ and is appropriate for the task. There is no set layout to follow in the OET writing task.Use accepted abbreviations:?– Candidates are allowed to use accepted abbreviations in the OET writing subtest. Before you use any short form or abbreviation, ensure you use the ______ ones used in the text. Answers are available at the back of this workbook.ACTIVITY 3A common problem for many students (which affects their score in the ‘linguistic features’ part of the exam) is that they struggle with articles.What is an article? Basically, an article is an adjective. Like adjectives, articles change nouns.English has two articles:?the?and?a/an.? The?is used to refer to specific or particular nouns;?a/an?is used to modify non-specific or non-particular nouns. We call?the?the?definite?article and?a/an?the?indefinite?article.the = definite articlea/an = indefinite articleFor example, if you say, "Let's read?the?book," I mean a?specific?book. If I say, "Let's read?a book," I mean?any?book rather than a specific book.Here's another way to explain it:?The?is used to refer to a?specific?or?particular?member of a group. For example, "I just saw?the?most popular movie of the year." There are many movies, but only one particular movie is the most popular. Therefore, we use?the."A/an" is used to refer to a?non-specific?or?non-particular?member of the group. For example, "I would like to go see?a?movie." Here, we're not talking about a?specific?movie. We're talking about?any?movie. There are many movies, and I want to see?any?movie. I don't have a specific one in mind.Let's look at each kind of article a little more closely.Indefinite Articles:?a?and?an"A" and "an" signal that the noun modified is indefinite, referring to?any?member of a group. For example:"My daughter really wants?a?dog for Christmas." This refers to?any?dog. We don't know which dog because we haven't found the dog yet."Somebody call?a?policeman!" This refers to?any?policeman. We don't need a specific policeman; we need any policeman who is available."When I was at the zoo, I saw?an?elephant!" Here, we're talking about a single, non-specific thing, in this case an elephant. There are probably several elephants at the zoo, but there's only?one?we're talking about here.Remember, using?a?or?an?depends on the sound that begins the next word. So...a?+ singular noun beginning with a consonant:?a?boy;?a?car;?a?bike;?a?zoo;?a?dogan?+ singular noun beginning with a vowel:?an?elephant;?an?egg;?an?apple;?an?idiot;?an?orphana?+ singular noun beginning with a consonant sound:?a?user?(sounds like 'yoo-zer,' i.e. begins with a consonant 'y' sound, so 'a' is used);?a?university;?a?unicycleIf the noun is modified by an adjective, the choice between?a?and?an?depends on the initial sound of the adjective that immediately follows the article:a?broken eggan?unusual problema?European country (sounds like 'yer-o-pi-an,' i.e. begins with consonant 'y' sound)Remember, too, that in English, the indefinite articles are used to indicate membership in a group:I am?a?teacher. (I am a member of a large group known as teachers.)Brian is?an?Irishman. (Brian is a member of the people known as Irish.)Seiko is?a?practicing Buddhist. (Seiko is a member of the group of people known as Buddhists.)Definite Article:?theThe definite article is used before singular and plural nouns when the noun is specific or particular.?The?signals that the noun is definite, that it refers to a particular member of a group. For example:"The?dog that bit me ran away." Here, we're talking about a?specific?dog, the dog that bit me."I was happy to see?the?policeman who saved my cat!" Here, we're talking about a?particular?policeman. Even if we don't know the policeman's name, it's still a particular policeman because it is the one who saved the cat."I saw?the?elephant at the zoo." Here, we're talking about a?specific?noun. Probably there is only one elephant at the zoo.Fill in the correct articles in the sentences below.1. I live in _____ state of California. (a, an, the) 2. Can you tell me _____ story. (a, an, the) 3. We will go to _____ mall tomorrow. (a, an, the) 4. I saw _____ lion at the zoo. (a, an, the)5. Will you watch _____ movie with me? (a, an, the) 6. I am going to _____ restaurant after school. (a, an, the) 7. We saw _____ great play. (a, an, the) 8. Would you like to eat ____ orange? (a, an, the)9. I would love to tell you _____ story. (a, an, the) 10. Can you take me to _____ doctor. (a, an, the) 11. We will go to _____ movies today. (a, an, the) 12. I saw all of _____ elephants at the zoo. (a, an, the) 13. Will you watch _____ play with me? (a, an, the) 14. I am going to _____ after school event. (a, an, the) 15. We saw _____ exciting basketball game. (a, an, the) 16. I saw _____ cat in my backyard. (a, an, the)Answers to this activity are available at the end of the workbook. ACTIVITY 4Tenses are another crucial element of grammar for OET. As you know, it is vital that healthcare professionals refer to a patient in the correct way. There is a big difference between “the patient is having a heart attack” and “the patient was having a heart attack.” One requires immediate medical attention and the other does not.Get into the habit of reading through your work to be sure you are referring to the patient in the correct tense.In the following exercises, fill in the correct form of the verb with the correct tense.1. They ___________________ in Chicago for 20 years (be). 2. I ___________________ a wonderful film in the cinema last night. (see) 3. The sun ___________________ at 6:38 yesterday morning (rise) 4. The sun ___________________ when the clim-ber reached Mount Everest. (shine) 5. I promise that I ___________________ this secret to anyone (not tell) 6. Unfortunately, just as we got to the airport their plane ___________________ off (take). 7. They ___________________ to the movies only once in a while (go) 8. I was tired yesterday because I ___________________ well the night before (not sleep). 9. Sh! Someone ___________________ to our conversation (listen)! 10. When I left the house this morning, it ___________________ (already rain) 11. I think Bob ___________________ for London this very moment.(leave) 12. The plane ___________________ off in a few minutes. (take) 13. I ___________________ up at 7 every morning but this morning I ___________________ long and I ___________________ up until 8. (get, sleep, not get) 14. I ________________________ my watch because it is being fixed (not wear). 15. This ___________________ an easy quiz so far (be). 16. They ___________________ in an apartment right now because they can’t find a cheap house. (live)17. Everyone ___________________ when the earthquake hit the small town. (sleep) 18. He _________________________ by herself since her divorce (live) 19. I was angry that I ___________________ such a stupid mistake (make). 20. I predict that by 2020, man __________________________ on Mars (land) Answers are available at the back of this workbook.ACTIVITY 5A conjunction is the part of speech used to join or link words, phrases, or clauses to each other. Conjunctions help to provide coherence to your writing by connecting elements between or within sentences and from one paragraph to the next in order to most effectively communicate your ideas to your reader. To achieve a Grade B in your OET writing exam, you should get into the habit of using a range of different conjunctions to link various pieces of information together relating to the patient. As you will need to summarise and condense the information from the case notes, conjunctions will have to become an area of English grammar that you are familiar with.Use a conjunction in the following circumstances:To show an additional or similar idea -- and, yet; not only . . . but also, both . . . and; after, although, even though, sinceTo show a contrasting idea -- but, yet; either . . . or, neither . . . nor; although, even though, unless, whereas To show cause or effect -- for, so; because, since, if, so that To show the relationship of time --and, but, so; when, whenever, until, before, after, while, once, as soon as, as long as To show the relationship of place --and, but; either . . . or, neither . . . nor; where, wherever To show purpose --and, so; not only . . . but also, whether . . . or, and both . . . and; in order that, so that Now, complete the following sentences by using the correct conjunction from the box below:center0howeveras thoughin caseto some extent as soon as considering in order to as long as since00howeveras thoughin caseto some extent as soon as considering in order to as long as since………………….. hard he tried, he still couldn’t understand the computer manual. They took ice-axes with them ………………….. they needed to cut steps in the ice.We have nothing to fear from our enemies ………………….. we keep our nerve.………………….. that this is Henry’s first competition, he has achieved a very respectable score.He became an American citizen ………………….. promote his business interests.“It looks ………………….. the same man committed both crimes.” said the inspector.While I accept your arguments ………………….., I cannot support the action you are taking. “………………….. the enemy crosses the stream, open fire!” said the captain. Answers to this activity are available at the end of this workbook. ACTIVITY 6Subject-verb agreement is an area of English grammar that many students struggle with in their OET writing exam. It is one of those grammar points that is easy to forget in the middle of an exam and so it is really worth spending some time familiarising yourself with the rules in advance so that it comes naturally to you on the day. Have a look at the information below and complete the exercises to develop your skills:What are verbs and subjects?Verbs are action words. For example: eat, sleep, talk, walk, do, buy are all verbs.Subjects are the person or thing who are doing the action of the verb. For example:I eat. The dog sleeps. George talks a lot. They walk to work.The subject of a sentence can be singular (one) or plural (many). For example:The computer is old. (singular) The computers are old. (plural)What is verb-subject agreement?The verb form can change depending on whether the subject is singular or plural. For example:The car park (singular subject) was (verb) full.The car parks (plural subject) were (verb) full.In these sentences each of the verbs agrees with its subject.How does verb-subject agreement work?In regular verbs:SingularPluralFirst personI like bananas.We like bananas.Second personYou like bananas. You like bananas. Third personHe/she/it likes bananas.They like bananas.Matching the verb and the subjectHighlight the correct form of the verb to match the subject. For example:This car (need) fixing.Correct answer: needs.Part AI (need) a rest.NeedNeedsShe (need) a holiday.Need NeedsThey (need) to go home.NeedNeedsAsif (need) to read more.NeedNeedsI (have) to see the doctor.HaveHasAnn (have) a bad back.Have HasWe (like) to watch TV.LikeLikesHe (like) to play football. LikeLikesYou (need) to look harder.NeedNeedsSara (want) more time.WantWantsHe (say) he wants to move out.SaySaysJane and Bill (make) sofas and chairs.MakeMakesShe (wish) she was on holiday.WishWishesThe car (need) a wash.NeedNeedsI (want) to learn FrenchWant Wants They (say) they’re going tomorrow.SaySays Problems with verb-subject agreementNot all verbs work in a regular way. Some of the most common verbs are irregular: eg be, go, do, have.Verbs and subjects must still agree, but you have to learn and remember the way the irregular ones work. Note the correct verb form for the third person singular for these irregular verbs:to do = I do - he/she/it does (not do)to have = I have - he/she/it has (not have)to go = I go - he/she/it goes (not go)For example:She does karate on Thursdays. They do lots of sparring.It has soft fur. They have soft hands.She goes sailing every month. I go every week.Too many wordsIt’s sometimes difficult to work out the subject if there are lots of words between the subject and the verb. For example:Steve, who has just returned from Australia, does not intend to go back.(Singular subject, ‘Steve’ = singular verb.)The children, excited about Father Christmas, have gone to bed early withoutcomplaining.(Plural subject, ‘children’ = plural verb.)Being able to spot mistakes in your own work when it comes to subject-verb agreement will be a crucial part of your proofreading process at the end of the exam. Have a look at the following article and try to choose the correct verb forms; watch out for the irregular verbs!Part BIN THE NEWSThe best job in the world?Some jobs is/are very demanding, but someone has/have to do them. Recently, Partnum & Brown was/were looking for a new chocolate buyer. The company was/were advertising a salary of ?35,000.The successful application had/have to travel the world to find the best chocolate makers. He or she would taste as much chocolate as possible, and then decide which was/were the best for their customers. They expected top quality for the world renowned Food Hall.The company was/were expecting a lot of applications for the job. They was/were looking for someone who worked hard, enjoyed food, had a keen eye for packaging and was/were able to control a budget. They also wanted someone who was/were enthusiastic, energetic and loved chocolate! Answers are available at the back of this workbook.ACTIVITY 7Throughout the OET writing exam you will be expected to interpret and understand the patient’s medical history. This can often by challenging as often ‘short-hand’ or ‘abbreviations’ are used. Your job during the exam is to transfer these case notes into easy to understand sentences. Let’s look at some examples of this.Read through the case notes below and decide what the note means in the box on the right using the full correct term.Case NoteWhat this means…BP ↑R/v req by attend. docTrauma → internal bleedBad nutri. Diet ↓0 childrenRamipril 5mg/dayCrutches 2 mth.PHX+ prog overall0 exercise post physi.Answers to this activity are available at the end of this workbook. ACTIVITY 8Now read through this essay below and suggest any improvements. Make any changes that you believe would help improve the grade of this assignment.Ms elizabeth ClarkeCommunity nurse ,community health centre10 lupus streetSeaview 2006Re: martha sculthorpe,75 years oldDear Elisabeth,I’m writing you to request a discharge plan for a patient which 10 days ago, more exactly on 14/5/2015 presented at hospital with infected arterial leg ulcer.consequently , after assessed her medical situation as nursing management, he needs to apply compression bandage after dressing ,moreover ,during hospitalisation with regard to her medication she has prescribed cephalexin for 10 days.In terms of her medical history she suffered from peripheral artery disease which started 10 years ago,furthermore the hypertension is another medical affection ,started 12 years ago and she takes verapamil 40 mg every daily. Additionally,she is widowed ,she lives alone and she lacks someone to care for her because her daughter fiona visits her twice a week ,she can assist a few days a week.therefore the patient accepted assistance from home care, but has refused meals on wheels.Apart from this was discussed with the patient about how important is to reduce the cigarettes .after the treatment which received along hospitalisation ,she has the discharge today on 24/5/2015.as assess the patient is afebrile, she need a walking stick for mobilising the pain, moreover she needs personal care as showering assistance.Despite all medical affections the wound of the patient should be much much better in 7 days after reapplication of compression bandage and she was announced that is schedule for review at dressing clinic in 2 weeks. In addition she needs to be encourage for continue reducing the cigarettes.Should you have any further inquiries, please do not hesitate to contact me. i have attached all the necesarry details along with this letter.Your sincerely,Charge nurseSuggested improvements:Capital letter on names ‘Elizabeth Clarke’ and ‘Martha Sculthorpe’. Further capitals required throughout such as on address and at start of paragraphs and sentences.Improvements on grammar: “I’m writing to you to request a…”Errors with articles “…with infected an arterial leg ulcer.”Spelling errors such as “necesarry”.Weak sentence structure and choice of words: “…and she takes verapamil 40 mg every day/daily.”Informal language such as “…much much better...”Some mistakes with plurals such as ‘…she needs a walking stick.”Letter is also above word count. No marks are deducted for this but information is not focused and does not flow coherently.What grade would you guess that this student achieved?Answer: DA sample answer to this task is available at the end of this workbook. ACTIVITY 9We also discussed the correct format of the letter. It is important that your essay flows naturally from one point to the other. Organise the following essay structures into the correct answer based on where they should be positioned in the essay. Write which paragraph the information should be placed into (1st paragraph, 2nd, 3rd etc) next to the structures. You may need to refer back to this week’s lesson for the correct structure.1. The reason you are writing = Paragraph …….2. Any secondary medical symptoms of problems. = Paragraph …….3. The patient’s main medical problem. = Paragraph …….4. Actions the patient’s nursing home needs to take. = Paragraph …….5. The type of letter you are writing (discharge, referral etc.) = Paragraph …….Now read through the writing exam sample answer below. Take the following actions:Re-order the paragraphs so that they follow the correct structure.Put the main medical issues in bold.Underline any further actions required.Put any further information in italics.Ms Georgine PonsfordResident Community NurseCommunity Retirement Home 103 Light Street, Newtown (Today’s date)Dear Ms Ponsford, Re: Mr Lionel Ramamurthy, aged 63 years You’ll be glad to know that Mr Ramamurthy has made good progress overall and is no longer feverish with his inflammatory markers having normalised. He does, however, still have a dry cough. In addition, his mobility has improved; he can now walk short distances without his walking frame as well as use the shower and toilet independently. I am writing regarding Mr Ramamurthy who will be discharged tomorrow (11/2) from Newtown Public Hospital back into your care following a bout of pneumonia. He was admitted with acute SOB, wheezing, painful coughing, fever, sleeplessness and general aches, and was hospitalised for seven days. Mr Ramamurthy will also need to be kept warm and encouraged to drink plenty of fluids during his recovery period. His diet will also need to be monitored as he did gain some weight during his stay. If you have any questions, please do not hesitate to contact me. Please make sure Mr Ramamurthy sits up as much as possible to ensure postural drainage. In addition, he will need to continue his deep breathing and coughing exercises (he may also need paracetamol for his chest and abdominal pain). Yours sincerelyMedical ProfessionalA corrected copy of this letter is available at the end of this workbook. IN THE NEXT LESSONWe will start to look at the Reading exam, considering in particular the skimming and scanning techniques that you will need to use for Part A of the Reading Exam. ANSWERSACTIVITY 1GroupedTensesOrganisedHaemoglobinDischarge planComplexCapital letterScores: B, B, C, C, BACTIVITY 2Layout and punctuationDeductedWord countProof-readAcceptedLaid outSameACTIVITY 3TheATheA/TheAAAAnAATheTheAAAnAACTIVITY 41. They have been in Chicago for 20 years (be). 2. I saw a wonderful film in the cinema last night. (see) 3. The sun rose at 6:38 yesterday morning (rise) 4. The sun was shining when the climber reached Mount Everest. (shine) 5. I promise that I will not tell this secret to anyone (not tell) 6. Unfortunately, just as we got to the airport their plane was taking off (take). 7. They go to the movies only once in a while (go) 8. I was tired yesterday because I had not slept well the night before (not sleep). 9. Sh! Someone is listening to our conversation (listen)! 10. When I left the house this morning, it was already raining (already rain) 11. I think Bob is leaving for London this very moment.(leave) 12. The plane will be taking/ will take off in a few minutes. (take) 13. I get up at 7 every morning but this morning I slept long and I didn’t get up until 8. (get, sleep, not get) 14. I am not wearing my watch because it is being fixed (not wear). 15. This has been an easy quiz so far (be). 16. They are living in an apartment right now because they can’t find a cheap house. (live) 17. Everyone was sleeping when the earthquake hit the small town. (sleep) 18. He has been living by herself since her divorce (live) 19. I was angry that I had made such a stupid mistake (make)20. I predict that by 2020, man will have landed on Mars (land) ACTIVITY 5howeverin caseas long asconsideringin order to as thoughto some extentas soon as ACTIVITY 6Part AneedneedsneedneedshavehaslikelikesneedwantssaysmakewishesneedswantsayPart BarehaswerehadwerewaswerewaswasACTIVITY 7Case NoteWhat this means…BP ↑Blood pressure increased/has risenR/v req by attend. docReview required by attending doctorinternal bleed→ traumaTrauma caused an internal bleedBad nutri. Diet ↓Bad nutrition. Dietary quality has decreased0 childrenNo childrenRamipril 5mg/dayRamipril 5mg per dayCrutches 2 mth.Crutches for 2 monthsPHXPatient history+ prog overallPositive progress overall0 exercise post physi.No exercise post/after physiotherapistACTIVITY 8Ms Elizabeth ClarkeCommunity Nurse Community Health Centre10 Lupus StreetSeaview 200624/05/2015Re: Martha Sculthorpe, 75 years oldDear Ms Clarke,I am writing to you to request your support regarding Martha Sculthorpe’s discharge plan. Mrs Sculthorpe was admitted to our hospital on 14/5/2015 due to an infected arterial leg ulcer. She is being discharged today. During her admission, Mrs Sculthorpe has been treated with cephalexin for 10 days and has undergone daily dressing with a compression bandage. The patient will continue to need the ulcer dressing following her discharge. In terms of the patient’s medical history, she has suffered from peripheral artery disease for 10 years. Furthermore, she has experienced hypertension for the past 12 years, for which she takes verapamil 40 mg every daily. Mrs Sculthorpe is widowed and lives alone. The patient’s daughter, Fiona, visits her twice a week but the patient does need more support than this. Therefore, she has accepted assistance from care but does not want to access the meals on wheels service. Going forward, Mrs Sculthorpe will need support with reducing her cigarette intake. Upon discharge, Mrs Sculthorpe will need a walking stick to mobilise and will require personal care, including assistance with showering. The patient’s ulcer wound needs to be reviewed at the dressing clinic in two weeks time. However, it is anticipated that wound will be much improved within the next 7 days, as long as the compression bandage is reapplied. Should you have any further inquiries, please do not hesitate to contact me. I have attached all the necessary details regarding this patient along with this letter.Yours sincerely,Charge NurseACTIVITY 91st 2nd 1st 3/4th1stMs Georgine PonsfordResident Community NurseCommunity Retirement Home 103 Light Street, Newtown (Today’s date)Dear Ms Ponsford, Re: Mr Lionel Ramamurthy, aged 63 years I am writing regarding Mr Ramamurthy who will be discharged tomorrow (11/2) from Newtown Public Hospital back into your care following a bout of pneumonia. He was admitted with acute SOB, wheezing, painful coughing, fever, sleeplessness and general aches, and was hospitalised for seven days. You’ll be glad to know that Mr Ramamurthy has made good progress overall and is no longer feverish with his inflammatory markers having normalised. He does, however, still has a dry cough. In addition, his mobility has improved; he can now walk short distances without his walking frame as well as use the shower and toilet independently. Please make sure Mr Ramamurthy sits up as much as possible to ensure postural drainage. In addition, he will need to continue his deep breathing and coughing exercises (he may also need paracetamol for his chest and abdominal pain). Mr Ramamurthy will also need to be kept warm and encouraged to drink plenty of fluids during his recovery period. His diet will also need to be monitored as he did gain some weight during his stay. If you have any questions, please do not hesitate to contact me. Yours sincerelyMedical Professional ................
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