Ask the child, then ask the nanny to explain the note to you. Do the listening, let her do the talking, don't preempt her by asking if she is feeling ok and needs time off. Make it all on her to explain. Then triangulate with what your child said and make your judgement.
It's not OK to write this to a 5 yo (if it was written to him), to me it would be a big deal, no matter how loud he is. Kindness is not optional, that note is very very rude.