Responses

1. 

   Perfecta Mamaculada May 27, 2021

   Ms. Cathy Ina
   Community Nurse
   6 Buchanan St,
   Glasgow G696DY, UK

   25 July 2018

   Re: Anna Dijana, aged 42

   Dear Ms. Cathy,

   I am writing in regards with Ms. Anna who is recovering from Fasciotomies and External Fixation Right Leg is about to be discharge today and needs continued care for her full recovery.

   She is a known case of Seizures and is on Carbamazepine. She is a school teacher, married, with 2 children. Also a social drinker but a non-smoker.

   On 15 July 2018, she came with pain on right knee from falling off stairs. She is diagnosed with Right Proximal Tibia Fracture and Lateral Tibial Plateau Fracture with Compartment Syndrome.

   She was then immediately rushed to Operating Room for a two-incision (4 compartments) fasciotomies and stabilized with external fixator. A wound vacuum is put in place.

   Post-operatively, she is resting comfortably, free of infection, vital signs are normal, wound is red in color, no drainage, no odor, no pain or swelling.

   Following discharge, kindly make sure Ms. Anna is aware about the signs and symptoms of infection, how to keep the surgical site clean, elevate the affected leg with a pillow while sleeping, and expect some drain amount in the wound vacuum. Remind her to notify immediately if any untoward changes.

   Thank you for taking over the care of Ms. Anna. Should you have further inquiries, please do not hesitate to contact me.

   Yours sincerely,

   Perfecta Mamaculada
   Registered Nurse
   New Victoria Hospital

   1. 

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2. 

   Gung Yu January 2, 2022

   Ms. Cathy Ina
   Community Nurse
   6 Buchanan St,
   Glasgow G69 6DY
   United Kingdom

   25 July 2018

   Dear Ms. Cathy,
   Re: Anna Dijana, 42 years old

   I am writing in regards to Ms. Anna, who was admitted in New Victoria Hospital following a fall resulting to fracture of her right tibial. She making a full recovery and wil be discharged today and would need your kind assistance for wound care management and follow ups.

   On admission last 15th of July, she was rushed in our hospital complaining of a right knee pain after falling from the stairs. She was not able to put any weight on her right leg and exhibiting signs of compartment syndrome. Immediately, Ms. Anna was sent to the OR for a two-incision fasciotomies of her right lower leg. Evidently, she also fractured her right proximal tibia and lateral tibial plateau, which was treated with external fixators.

   Ms. Anna has been recovering well from her surgery, with no evidence of infection of her surgical wound. She also did not reported any pain and her vitals remained within the normal parameters.

   I appreciate if you could continue advising Ms. Anna about wound care management by making sure that she notifies any signs of infection and that she knows of what is an abnormal wound drainage. Please make sure that she keeps blankets and clothing away from the wound area and weight should not be applied to her right leg.

   Should you have any clarifications, please feel free to contact me.

   Yours truly,

   Nurse

   1. 

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3. 

   Gung January 2, 2022

   Ms. Cathy Ina
   Community Nurse
   6 Buchanan St,
   Glasgow G69 6DY
   United Kingdom

   25 July 2018

   Dear Ms. Cathy,
   Re: Anna Dijana, 42 years old

   I am writing in regards to Ms. Anna, who was admitted in New Victoria Hospital following a fall resulting to fracture of her right tibial. She will be discharged today and would need your continued care for her full recovery.

   On admission last 15th of July, she was rushed in our hospital complaining of a right knee pain after falling from the stairs. She was not able to put any weight on her right leg and exhibiting signs of compartment syndrome. Immediately, Ms. Anna was sent to the OR for a two-incision fasciotomies of her right lower leg. Evidently, she also fractured her right proximal tibia and lateral tibial plateau, which was treated with external fixators.

   Ms. Anna has been recovering well from her surgery, with no evidence of infection of her surgical wound. She also did not reported any pain and her vitals remained within the normal parameters.

   I would appreciate if you could continue her wound care management by making sure that blankets, clothing or any articles should be kept away from the wound area. Most importantly, please advise Ms. Anna to report any signs of infection like abnormal drainage.

   Should you have any clarifications, please feel free to contact me.

   Yours truly,

   Nurse

4. 

   Gung January 2, 2022

   Ms. Angelina Hawker
   Senior Nurse
   Parker Nursing Home
   28 Hilly Road

   7 October 2019

   Dear Ms. Angelina,
   Re: John Simpsons, 78 years old

   I am writing in regards to Mr. John, a married retired engineer who is recovering from his left total hip replacement. He is now ready to be discharged today back in your care.

   Mr. John was admitted in our hospital last 3rd of October 2019, following a severe progression of his osteoarthritis, which was known since 2018. Later that day, he was scheduled for an elective left total hip replacement.

   He has been showing a good recovery after his surgery as evidently, Mr. John has been ambulating using his walker without any difficulty. However, disorientation to time and place has been noted, probably caused by the anaesthesia.

   He has been managed with Panadeine Forte 550/30 mg, 2 tablets four times daily as needed for pain relief. Also, he takes Ramipril 5 mg and Aspirin 100 mg one tablet in the morning.

   I would apprecite if you could provide his continued care by monitoring his medications and observing the surgical site for infectiany on. For his ADLs, you may need a wheelie walker, wedge pillow and a toilet raiser. Our hospital will be able to provide these immediately except for the toilet raiser, which will be arranged by a social worker in 2 weeks time. In addition, his hemoglobin has been stable recently, but continued assessment is necessary.

   Lastly, he needs a follow up after 2 weeks in Fortis Hospital Clinic for FBE, UEC and staples removal.

   Should you have any clarifications, please feel free to contact me.

   Yours truly,

   Nurse

   1. 

      Yi Deng February 8, 2023

      Ms. Cathy Ina
      The Community Nurse
      Baillieston Community Care
      6 Buchanan St
      Glasgow G69 6DY
      UK

      24th July 2018

      Dear Ms. Ina
      Our patient Ms Ann Dijana was admitted on 15th July 2018 suffering from Compartment Syndrome and Fracture, and she is expected to be discharged from our facility back into your Care for the comprehensive rehabilitation tomorrow.

      Upon arrival, Ms.Dijana complianed that her knee on right side was painful due to injury caused by falling down on the floor from stairs. At that time, her impaired leg could not support the weight which has already effected her daily activities and sleeping.

      This patient was in a hurry to be arranged the surgery of open reduction with two incision fasciotomies of her leg at right lower side. After the operation, she was stable and external fracture fixation was applied. Medications to relieve pain were administered by the doctor. Vaccination for the wound to prevent tetanus was also given.

      So far, Ms. Dijana’s vital signs are within normal range. She feel painless and is able to sleep as well. In addition, there is no wound infection during ten days treatment and nursing care. Overall, her health condition has improved a lot.

      Kindly provide methods to the patient about maintaining aseptic status around wound area and the way to define infection. For instance, make sure not to touch the quilt or any other things and observe if the region becomes red and swollen. Informing her to notify the nurse ASAP when any abnormalities are discovered. Furthermore, please educate her that clear and less amount of drainage presents the wound is under healing process.
      If you have any inquiries, please do not hesitate to contact me.

      Yours sincerely

      Nurse

5. 

   Yi Deng February 8, 2023

   Ms Angelina Hawker
   Senior Nurse
   Parker Nursing Home
   28, Hilly Road

   6th October 2019

   Dear Ms Angelina Hawker

   Re: Mr. John Simpsons, aged 78

   Thank you for taking over the charge of our patient Mr.Simpsons’ post-hospital nursing care. I am writing to provide you some information about his pre- and in-hospital conditions as well as the plan to promote recovery. He is prepared to be discharged tomorrow that needs your continuing care for his whole rehabilitation.

   On admission, the patient had such a poor health with exacerbating Osteoarthritis diagnosed in the year of 2018 which resulted in his ambulatory problem, especially, he could not go up and down stairs. Earlier in 1991, he was found with high blood pressure which is kept under control persistently.

   During the time staying in hospital, Mr. Simpsons received an operation of Left Total Hip Replacement successfully. Aspirin was advised upon surgery. Ramipril was administered and Panadeine Forte was prescribed for two pills four times a day as necessary to relieve pain. The dressing at wound area was changed every day. Exercises and physical therapy were applied. Blood transfusion was given due to fairly low level at 72 g/dL.

   After four days treatment and post-operative care, the patient is now stable and getting well gradually in an optimal situation. He can walk well with walker for a ward distance. However, since the side effect of anesthesia has not gone completely, confusion is still exist and should be monitored together with hemoglobin value to prevent drop.

   Kindly appreciate to constantly check skin intactness and medication daily. Encouraging the patient to do exercises regularly. Moreover, to better assist his ADLs, our hospital is able to provide the walker and pillow using in your facility. A social worker will arrange the raiser for they have activated raiser rental in two weeks.

   Yours faithfully

   Nurse

6. 

   Yi February 8, 2023

   Ms. Cathy Ina
   The Community Nurse
   Baillieston Community Care
   6 Buchanan St
   Glasgow G69 6DY
   UK

   24th July 2018

   Dear Ms. Ina

   Re: Ms. Ann Dijana, 42 years old

   Ms Ann Dijana was admitted on 15th July 2018 suffering from Compartment Syndrome and Fracture, and she is expected to be discharged from our facility tomorrow.

   Upon arrival, Ms.Dijana complianed that her knee on right side was painful due to injury caused by falling down on the floor from stairs. At that time, her impaired leg could not support the weight which has already effected her daily activities and sleeping.

   This patient was in a hurry to be arranged the surgery of open reduction with two incision fasciotomies of her leg at right lower side. After the operation, she was stable and external fracture fixation was applied. Medications to relieve pain were administered by the doctor. Vaccination for the wound to prevent tetanus was also given.

   So far, Ms. Dijana’s vital signs are within normal range. She feel painless and is able to sleep as well. In addition, there is no wound infection during ten days treatment and nursing care. Overall, her health condition has improved a lot.

   Kindly provide methods to the patient about maintaining aseptic status around wound area and the way to define infection. For instance, make sure not to touch the quilt or any other things and observe if the region becomes red and swollen. Informing her to notify the nurse ASAP when any abnormalities are discovered. Furthermore, please educate her that clear and less amount of drainage presents the wound is under healing process.
   If you have any inquiries, please do not hesitate to contact me.

   Yours sincerely

   Nurse

7. 

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8. 

   Edlyn September 20, 2023

   Cathy Ina
   Community Nurse
   6 Bucharan St
   6 Glasgow G696DY UK

   25 July 2018

   Dear Ms Ina
   RE: Anna Dijana, age 42

   Ms. Anna Dijana was admitted on 15 July 2018 having diagnosed with right proximal tibia fracture and lateral tibial plateau fracture, Compartment syndrome. She is now ready for discharge back into your care.

   On admission, Ms. Dijana complains of right knee pain following an incident of fall with difficulty bearing weight on the same leg. Due to her condition, she was immediately managed inside the OR for two-incision fasciotomy and external-fixation succeedingly.

   Post- operatively, Ms. Dijana’s affected leg has been stabilized and she has taken medication for pain. Nursing management includes wound vac on fasciotomy incisions. Assessment reveals no signs of infection, no odor or redness, no swelling or pain on the wound site. Her recovery condition is generally well.

   I would appreciate if you could instruct Ms. Dijana on appropriate wound care giving emphasis on keeping the site sterile and free from any clothing. Most importantly, please ensure to provide education on the signs and symptoms of infection and expected drainage so she can report any unusuality.

   Thank you for your continued management.

   If you have any queries, please feel free to contact me.

   Yours sincerely

   Nurse
   The New Victoria Hospital