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频道帖子
Ms Geargine Ponsford Resident Community Nurse Community Retirement home 103 Light Street Newtown Dear Ms Ponsford, Re: Mr Lionel Ramamurthy, aged 63 I am writing to update you regarding Mr Ramamurthy who was admitted on 03/02/2019 with the diagnosis of pneumonia. He is ready for discharge back into your facility. On admission, he was experiencing a fever and rigours as well as suffered with shortness of breath , wheezing and sleepessness .He had chest and abdominal pain due to prolonged persistent cough . He was able to walk with the help of a frame and assisted with activities of daily living such as showering and dressing etc. After a week in hospital , he has stabilised and his breathing problems are now resolved ;however , he is still experiencing some chest and abdominal pain with a dry cough. On assessment, he can walk independently. In addition, he can use the toilet and get a shower without assistance. He gained weight; therefore, he was reviewed by dietition. Given the above, it would be greatly appreciated if you could encourage him for oral fluids and give him a properly nutritious diet. He needs to ambulate regularly and continue his deep breathing and coughing exercises. Please ensure he sits up rather than lies down to ensure postural drainage. Paracetamol can be given if needed for pain .kindly he should be kept warm Should you require any information, please do not hesitate to contact me Yours sincerely, Registered nurse

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QQ.NW.11. Mr Lionel Ramamurthy – Pneumonia – Alina Dunea – Bucharest | Romania
QQ.NW.11. Mr Lionel Ramamurthy – Pneumonia – Alina Dunea – Bucharest | Romania
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QQ.NW.11. Mr Lionel Ramamurthy – Pneumonia – Alina Dunea – Bucharest | Romania Ms Georgine Ponsford Resident Community Nurse Community Retirement Home 103 Light Street Newtown 10th February, 2019 Dear Ms Ponsford, Re: Mr Lionel Ramamurthy, 63-year-old I am writing in regards of Mr Ramamurthy who has been admitted to Newtown Public Hospital on the 4th of February 2019 due to pneumonia and is being discharged back to you tomorrow, the 11th of February for further care and management. Mr Ramamurthy suffered from acute shortness of breath, inspiratory and expiratory wheezing, persistent cough along with chest and abdominal pain, fever, insomnia and generalized ache due to his pneumonia. On admission, he mobilised with the help of pick-up frame and received assistance with ADLs, he was weak and experienced shortness of breath on exertion. Mr Ramamurthy is currently afebrile and his inflammatory markers are back to normal. His walk and ADL have evolved into a slow, but independent one, his cough is dry and accompanied by some chest and abdominal pain. In addition, he was post reviewed by a dietician and he has gained weight (1.5 kg). He is registering good progress overall. Mr Ramamurthy s intake of oral fluids and adequate nutrition is to be stimulated. His diet should include increased fluids, eggs, fruits and vegetables and needs help monitoring. Apart from this, chest physio is to be performed and postural drainage is important to be achieved through sitting while avoiding rather than lying down. Paracetamol is recommended/ should be taken in case of abdominal pain and it is best for Mr Ramamurthy to be kept warm. Moreover, his physio review revealed he is ambulant. Furthermore, his eyesight dropped due to cataracts removal sixteen months ago and needs examination. If you have further queries, please do not hesitate to contact me. Yours sincerely, Nurse
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QQ.NW.10. Mr Lionel Ramamurthy – Pneumonia – Leemol Varghese – Kerala | India
QQ.NW.10. Mr Lionel Ramamurthy – Pneumonia – Leemol Varghese – Kerala | India
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QQ.NW.10. Mr Lionel Ramamurthy – Pneumonia – Leemol Varghese – Kerala | India Ms Georgine Ponsford Resident Community Nurse Community Retirement home 10 february 2014 Dear Ms Ponsford, Re: Mr Lionel Ramamurthy, 63 years I am updating the current health status of Mr Ramamurthy who is recovering from pneumonia. He requires ongoing care at your facility. He will be transferred to your facility tomorrow. On admission, Mr Ramamurthy was very weak, ambulating only short distance with increasing shortness of breath on exertion. He was using a pick up frame for ambulation. He also had dry cough, stomach and abdominal pain. During hospital stay, he was encouraged to consume more oral fluids and healthy diet by a dietician. Therefore, he gained weight. He also reviewed by a physiotherapist for his ambulation. Now he is independent in walking and activities of daily living. He was suggested to perform deep breathing and coughing exercises. He was also instructed to prefer sitting rather than lying down inorder to ensure postural drainage. Currently, Mr Ramamurthy’s condition has progressed well. Kindly monitor his diet and encourage him to take increased fluids, eggs, fruits and vegetables in his diet. Please note, tablet paracetamol can be given to him if he has chest or abdominal pain. Please keep him warm. Please do not hesitate to contact me for further queries. Yours sincerely, Charge Nurse
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QQ.NW.10. Mr Lionel Ramamurthy – Pneumonia – Leemol Varghese – Kerala | India+1
QQ.NW.10. Mr Lionel Ramamurthy – Pneumonia – Leemol Varghese – Kerala | India
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QQ.NW.9. Mr Lionel Ramamurthy – Pneumonia – Amutha Mercy – Saudi Arabia | India+1
QQ.NW.9. Mr Lionel Ramamurthy – Pneumonia – Amutha Mercy – Saudi Arabia | India
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QQ.NW.9. Mr Lionel Ramamurthy – Pneumonia – Amutha Mercy – Saudi Arabia | India 11 February 2019 Ms Georgina Ponsford Resident Community Nurse Community Retirement Home 103 Light Street Newtown Dear Ms Ponsford, Re : Mr Lionel Ramamurthy, aged 63 I am requesting you regarding Mr Ramamurthy; a known case of your's who requires your continued follow-up care and support, as he is recuperating from pneumonia. He is being discharged tomorrow. Mr Ramamurthy was admitted to hospital on 04 February 2019 with the complaints of acute shortness of breath, inspiratory and expiratory wheezing, persistent cough, fever, sleeplessness and Generalised ache. He was mobilized with pick-up frame. He was gained 1.5kg weight. During hospitalization, Mr Ramamurthy was responded well for the treatment. He consumed oral fluids and took proper nutrition. He was preferred to lying down to ensure postural drainage. He was ambulant as per physio. Mr Ramamurthy is retired school teacher, financially independent, lives alone since his wife died. He was lost his weight around 4kg in 6 months due to poor diet. Upon discharge, kindly provide warm environment, please encourage him to consume plenty of fluids, eat egg, fruits and vegetables. Kindly monitor him for dietary intake. Please note, advise him to take paracetamol if he feels chest pain or abdominal pain. Thank you for agreeing this matter and please do not hesitate to contact me for further queries. Yours sincerely, Charge Nurse Medical ward Newtown Public Hospital
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QQ.NW.8. Mr Lionel Ramamurthy – Pneumonia – Neetu Baby – Kerala | India
QQ.NW.8. Mr Lionel Ramamurthy – Pneumonia – Neetu Baby – Kerala | India
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QQ.NW.8. Mr Lionel Ramamurthy – Pneumonia – Neetu Baby – Kerala | India+1
QQ.NW.8. Mr Lionel Ramamurthy – Pneumonia – Neetu Baby – Kerala | India
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QQ.NW.8. Mr Lionel Ramamurthy – Pneumonia – Neetu Baby – Kerala | India ## ROUND 1 — STAGE 1 — MANUSCRIPT SUBMISSION ### A. Manuscript Receipt Both handwritten manuscript pages have been received in the correct sequence. ### B. Complete Faithful Electronic Typescript Mrs Georgine Ponsford Resident Community Nurse Community Retirement Home 103 Light Street Newtown 11 February 2019 Dear Mrs Ponsford, R: Mr Lionel Ramamurthy, aged 63 I am writing to refer Mr Ramamurthy back to yours facility who requires an ongoing care and management. He was diagnosed with pneumonia. He will be discharged tomorrow. Mr Ramamurthy was admitted to the hospital on 04 February 2019 with complaints of acute shortness of breath, fever, rigors, sleeplessness, generalised ache, chest and abdominal pain due to persistent cough along with wheezing. In addition, he reported that he can ambulant only short distance with pick-up frame. During hospital stay, he were encouraged for oral fluids and proper nutrition along with chest physiothoriopy. He was provided with dietary and physiotherapy. At present, Mr Ramamurthy’s inflammatory markers were normal limits and independently do day to day activities. Eventhough, he has dry cough, chest and stomach pain. Upon discharge, it would be greatly appreciated if you could monitor his diet regimen and encourage him to keep warm. Please provide paracetamol to him for chest and abdominal pain if necessary. Please contact me if you have any queries. Yours sincerely, Charge Nurse Medical Ward Newtown Public Hospital 41 Main Street Newtown
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QQ.MW.15. Ms Anne Hall – Gastro-Oesophageal Reflux – Dr Nuzhat Irfan – Islamabad | Pakistan
QQ.MW.15. Ms Anne Hall – Gastro-Oesophageal Reflux – Dr Nuzhat Irfan – Islamabad | Pakistan
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QQ.MW.15. Ms Anne Hall – Gastro-Oesophageal Reflux – Dr Nuzhat Irfan – Islamabad | Pakistan Dr.Jason Roberts The Gestroenterologist Newtown Hospital 111High Street Newtown 18 June 2018 Re:Ms Anne Hall DOB:19 September1972 18June 2018 I am writing to refer Me Hall,a-45- year old school teacher presented whose signs and symptoms are suggestive of gastroesophagel stricture.Your further opinion and endoscopy regarding her situation would be highly appreciated. MS Hall is divorced with two children.She did not smoke.However she drinks spirit socially.It is important to be noted that she is allergic to codeine,dust mites,sulphur dioxide.Since her childhood she was suffering from asthma.She had a strong family history of asthma. On reviewing her past medical history,Ms Hall underwent tonsillectomy and sebaceous cyst removal surgery.Upper respiratory tract infection is off and on.But along with it she suffered from dyspepsia as well.Depression may caused a lot of changes in her body weight her BMI is 28.2. On her today's visit,was complaining of difficulty in a swallowing of solid food She reported that due to her upper respiratory tract infection 2 weeks ago,she used to take over the counter herbal chinese medicine.Now she has epigastric pain because of increase in coffee intake. In view of the above,you are requested to manage her condition accordingly.She was commenced on pantoprazole 40 kg daily and to reduce her coffee intake.Should there be any queries,please do not hesitate to contact me. Yours sincerely Doctor
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QQ.NW.7. Mr Lionel Ramamurthy – Pneumonia – Sruthy Sukumaran – Kerala | India Ms Georgine Ponsford Resident Community Nurse Community Retirement Home 103 Light street Newtown 11 February 2019 Dear Ms Ponsford Re: Mr Lionel Ramamurthy, Aged 63 The purpose of this letter to refer Mr Ramamurthy back to your care, who has been recovering from pneumonia. He is due for discharge today. On 04 February 2019, Mr Ramamurthy was admitted with shortness of breath and unbering the had chest and abdominal pain associated with persistent cough. He was experiencing generalised aches, fever, fatigue and sleeplessness. He was unable to do daily living activities independently. During hospitalization, Mr Ramamurthy was recommended with deep breathing and coughing exercises to enhance lung capacity. Physiotherapy was also given to him to improve physical stability. Dietary changes has been initiated as he had significant weight loss. Currently, his clinical status is well improving It would be highly appreciated if you could arrange a better and warm atmosphere for Mr Ramamurthy. Ensure high quality diet with proteins, vegetables, egg and encourage him to have more fluids. Sitting position is highly suggested for him to increase postural drainage. Paracetamol can be given to him if he feels chest or abdominal pain. Your expertise monitoring and management is highly commendable. In case you require any additional information please do not hesitate to contact me Yours sincerely, Charge Nurse.
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QQ.NW.7. Mr Lionel Ramamurthy – Pneumonia – Sruthy Sukumaran – Kerala | India+1
QQ.NW.7. Mr Lionel Ramamurthy – Pneumonia – Sruthy Sukumaran – Kerala | India
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QQ.NW.6. Mr Lionel Ramamurthy – Pneumonia – Anila Shyam – Kerala | India Ms Georgine Ponsford Resident Community Nurse Community Retirement Home 123 Light Street Annetown 11 February 2019 Dear Ms Ponsford, Re: Mr Lionel Ramamurthy, aged 63 I am writing to sent back Mr Ramamurthy, into your care, who was diagnosed with Pneumonia. He requires ongoing care and assistance from your service following his discharge tomorrow. During hospitalization, Mr Ramamurthy complaints of acute shortness of breath, fever and rigor. Furthermore, in addition, he experienced persistent cough associated with chest and abdominal pain.and wheezing . also On examination, he had increased temperature with tachypnoea and generalized adventitious sounds. Please note he has weight loss associated with poor diet-During hospitalization, he was managed with deep breathing and coughing exercises. Whilst the hospital, his mobility has improved, he can walk short distances without his walking frame as he can use the shower and toilet independently. Currently, he made good progress and his cough increased is also noted by his dietition during the confinement period. Kindly Please encourage Mr . Rama murthy to increase oral intake and appropriate nutrition especially eggs, fruits and vegetables in order to keep him warm. Kindly administer paracetamol if he experience abdominal and chest pain. Moreover, he should sit more often rather than lying down to ensure postural drainage. If you have any quires,please do not hesitate to contact me. Yours Sincerely, Charge Nurse
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