Problem 4

Margaret is a 20 YO female who was involved in a single vehicle accident one year ago. She was comatose for three months, with the first volitional movement observed being tongue thrusting on request. Margaret was transferred from the acute care facility to a free standing rehabilitation unit for 5-6 months. From there she traveled to a transitional head injured unit in the southern part of the state for 2 months. Margaret is now home and you are providing outpatient care.

Subjective:

• -Margaret was living in her own apartment prior to the accident
• -Margaret was an honor role student at a local community college
• -Margaret's family is very supportive and well educated
• -The tracheostomy incision is well healed

Objective:

• -Margaret demonstrated hypertonicity throughout the L side
• -Margaret is currently wheelchair bound
• -Margaret speaks with difficulty, but is understandable with careful listening

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