Case Study: Mackenzie Lynn
Read the narrative report for Mackenzie Lynn before you view the life care plan. Read the information, and assume that this is information that you collected during your clinical interview with Mackenzie.
Identify the following key elements of the case:
- What is Mackenzie’s current diagnosis?
- What are her physical limitations?
Based on Mackenzie’s information, determine what recommendations should be made in her life care plan. Include the purpose for each item, the beginning and ending dates for each item, and the frequency of replacement schedule for the items. You may want to refer to page 6 of your Life Care Planning and Case Management Handbook for the Life Care Plan checklist.
To view the narrative report for Mackenzie Lynn, click here for the document.
- Mackenzie developed purpura fulminans resulting in bilateral above knee amputations, below the elbow amputation of right arm and above the elbow amputation of the left arm.
- Mackenzie’s physical limitations include
- Loss of Tactile Sensation: She has altered sensation in the residual limbs of both arms. She can feel hot and cold, but touch is dulled. She has loss of sensation and numbness in the scarring areas of her residual limbs on both lower extremities. Left residual upper extremity has some hypersensitivity to light touch with a shock-like sensation. This is only occasionally and depends on where it is touched.
- Reach: She has full range of motion in her shoulders without pain or limitations.
- Lift: She can pick up a water bottle using both upper extremity residual limbs. No other ability to lift.
- Prehensile/Grip: She has no ability to grip. She can sign her name using her mouth to hold the pen and guiding it with her arms.
- Sitting: Extended sitting can cause her to have pain in her lower extremity residual limbs. Also will cause phantom pains. She has pain in her lower back with extended sitting. She will stay in her wheelchair for about 2 hours at a time and then switch to the bed or a chair to rest. She will usually rest for about 30 minutes then transfer back into her wheelchair.
- Standing: She can stand using her prostheses, but someone has to put her into a standing position. Once she is in a standing position, she can maintain her standing balance.
- Walking/Gait: She can walk about 40 to 50 feet using her prostheses. This is with someone walking in front of her and behind to catch her when she falls. She is working on walking 5 days per week with the prosthetist now. She can not stand and walk on her residual limbs, but she can scoot on the floor from place to place by moving her hips.
- Bend/Twist: She can bend at the waist without discomfort.
- Kneel: Nonfunctional.
- Stoop/Squat: Nonfunctional.
- Climb: Nonfunctional.
- Balance: Good.
- Breathing: No dyspnea.
- Headaches: She has daily headaches, and she attributes this to insomnia. She feels tired, and then she will get a headache. She does not take anything for her headaches.
- Vision: Intact.
- Hearing: Intact.
- Driving: No driving evaluation. She will need adaptive equipment, but she should be able to learn to drive with training. She did drive prior to injury.
- Physical Stamina (average daily need for rest or reclining): She tires easily, and she has insomnia, so she does not feel that she is getting enough rest. She is prescribed Ambien, and she takes one half a night, but it is not providing her with much relief from insomina.
- To view the life care plan for Mackenzie Lynn, click here for the document.
- To view the potential complications for Mackenzie Lynn, click here for the document.