Re: Mr Walter Pitman, aged 69
I am writing to refer Mr Pitman for your full cardiac assessment and management of hypertension.
Mr Pitman arrived in care of Nurse-led outpatient clinic with severe pain of 8/10 on pain scale with hematoma, following his discharge from Newtown Hospital yesterday, where he was being admitted for deep lacernations on his left lower arm. On observations, his BP 186/89 mmHg being in sitting position but 190/86mmHg on supine position.
Mr Pitman has a medical history of hypertension since 2008 and BMI 30 but not exercising. He is 9 non-smoker nor alcoholism.
Two days later, BP seemed to be Elevated which was 186/89 mmHg in sitting position but in supine position still the same which was 190/86 mmHg.
Following her next 3 more visits, BP was gradually elevating especially systolic pressure though the wound being cleaned and healing well without infection.
On today’s observation BP increased to 190/84 mmHg (sitting) and 196/86 mmHg in supine position, therefore Mr Pitman requires your cardiac assessment for hypertesion and management.
Please do not hesitate to call me if there is any query regarding Mr Pitman.