Assignment Task:
Task:
Identifying a research question and its significance to Intensive Care Nursing Recent advances in the management of Atrial Fibrillation in post cardiac surgeries Atrial Fibrillation (AF) is the most common arrhythmia complicating cardiac surgery (Rho 2009). The prevalence of post operative AF is more common than before due to increased number of cardiac surgeries (Alqahtani 2010). The incidence of AF following cardiac surgery is approximately 30% after Coronary Artery Bypass Graft (CABG), 40% following valve replacements or repair, and 50% after combined CABG / valvular procedures (Alqahtani 2010). AF is tend to occur within two to four days post operatively, with the peak on the second day (Mostafa et al. 2012). This in turn associated with significant mortality, morbidity, post operative complications, longer hospital stay and cost of hospitalization (Moss et al. 2017). Pericardial inflammation, excessive production of catecholamines, heightened sympathetic and parasympathetic tone, atrial stretch, transcellular fluid and electrolyte shifts, and metabolic abnormalities attributed to the development of AF post operatively (Alqahtani 2010; Arrigo, Bettex & Rudiger 2014). Therapeutic strategies for critically ill patients with AF post cardiac surgeries are different from those without surgeries (Rho 2009). Therefore, Critical care nurses and doctors should be aware of management options (Sibley & Muscedere 2015). Certain cardiac intensive units across Australia and New Zealand have protocols for AF prophylaxis after cardiac surgeries which include supplementation of magnesium and electrolytes, routine use of β-blockers and amiodarone (Alawami et al. 2018). It is important for each hospital to have a well-developed protocol for AF prophylaxis which should improve the surgical outcome and reduce healthcare cost (Alawami et al. 2018). Limitations There is lack of high quality evidence regarding nursing management of AF in post cardiac surgeries. However, several strategies have been published for the prevention and management 2 of AF. It is important to develop an integrated medical and surgical protocol for the prophylaxis of AF after cardiac surgery (Alawami et al. 2018). This assessment is to discuss recent advancement in the management of AF in post cardiac surgeries. Evidence have suggested prophylactic treatment schedule for AF. Certain hospitals have implemented those evidence into practice with positive outcome. This assessment will discuss few management options for AF, which are relevant for critical care nurses when nursing cardiac patients. Intensive Care Nursing and Medical management of AF
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