recovery process

Jane is an 85 Year old female. Her husband passed away 5 years ago. Her daughter Cathy lives interstate and only visits her twice a year. Jane lives by herself. She is a member of the local lawn bowling club which she is a very active in the club’s activities which include fund raising, charity work and the day to day operations of the club. All of her friends are members of the club as well. Jane has a medical history of CCF. Her medications include Frusemide, Span K and Imdur. Jane has noticed that in the last 3 months feeling dizzy on occasions. During a game of lawn bowls she felt dizzy and collapse. She was taken to the hospital by the paramedics. After further investigations she was diagnosed with Symptomatic bradycardia (HR 25-30bpm). She was reviewed by the Cardiologist team and recommended an insertion of a permanent pace maker. Jane consented to the surgical intervention which is scheduled the next day. The next day she was taken to the OT for an insertion of PPM. Her surgery was uneventful andwas transferred to the PACU. Whilst recovering in PACU, it was noted that she had her skin was pale, sweating, difficulty breathing and was coughing up frothy sputum that has a tinge of pink in it. Her vital signs are as follows HR 112, BP 90/40, SpO2 91% on 6L/min via Hudson mask. The medical officer is contacted to review and treat Jane. It was diagnosed that Jane was experiencing Acute Pulmonary Oedema (APO).After resolving Jane’s APO episode, it was observed that she was disorientated and speaking inappropriate statements such as ‘I need to go to the club to sell the rest of the raffle tickets’ and ‘the money that the club raised won’t be enough to buy the TV needed for the Starlight foundation.’ After recovering, she was taken to the Cardiology ward and was placed on cardiac monitoring. Her surgical site which is located on her left upper chest shows no signs of bleeding. Jane has been prescribed with IM morphine 2.5 mg fourth hourly and oral Paracetamol (6th hourly). She mentions that even with the pain relief she still feels pain on her surgical site (pain score 5/10). She asks for another alternative to relieve her pain.
Answer the following 4 questions
Q1. Identify the psychosocial impact of surgical intervention including the psychosocial impact of elective and emergency admissions, separation, and loss of income and/or loss of control as related to the case study (400 words)
Q2. Explain the recovery process of your chosen patient whilst they are in the Post-Anaesthetic Care Unit (PACU). Identify and provide rationale for airway management as related to the case study (250 words)
Q3. Identify and discuss appropriate pharmacological and non-pharmacological measures including analgesia, sensory experiences and positioning as related to the case study. (250 words)
Q4. Develop a (case report) nursing care plan focusing on the post operative care in the first 24 hours upon return to ward. In order of priority, using evidence based literature, identify and discuss nursing care and rationales as related to the case study. Nursing care presented needs to be specific to the patient. Answers presented in question 2 and 3 should not be presented in question 4

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