The first article, Changes in Mitral egurgitation After eplacement of the Stenotic Aortic Valve (2008) stresses a relatively large patient study of those undergoing Aortic valve replacement and then possibly experiencing mitral regurgitation (M), a common and sometimes concerning complication that as the study shows can occur without any known mitral defect. The study is significant in that it establishes the fact that M is not as dangerous as once thought and can be resolved without further surgical intervention in many patients, where as in the past further surgical intervention was the most likely outcome. The study also indicated certain precursors or markers that allows the initial surgical screening of patients who would benefit from mitral surgery, prior to mitral failure and could therefore receive the procedure during the initial surgical intervention, rather than as a separate surgical event. It is clear that the common sense of this study is…...

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Resources

Massachusetts General Hospital Thoracic Aortic Center Website. Retrieved August, 15, 2008

 http://www.massgeneral.org/tac/about/ 

Arvind K. Agnihotri, M.D." Massachusetts General Hospital Thoracic Aortic Center Website Our Staff. Retrieved August, 15, 2008  http://www.massgeneral.org/tac/page.asp?id=agnihotri .

Jassal, D.S. MD, Neilan, T.G. MD, Pradhan, a.D. MD, Lynch, K.E. RN, Vlahakes, G. MD, Agnihotri, a.K. MD, Picard, M.H. MD (2006) Surgical Management of Infective Endocarditis: Early Predictors of Short-Term Morbidity and Mortality. Annals of Thoracic Surgery (82) 524-529.

Does taking Metoprolol before cardiac surgery reduce the incidence of post-op atrial fibrillation Abstract
Postoperative atrial fibrillation (POAF) remains a prevalent supraventricular arrhythmia. PoAF has associated effects such as deteriorating hemodynamic, increased risk of stroke and increased probability of death. Beta-blockers have been recommended as effective intervention mechanism of preventing PoAF. Metoprolol is one such beta-blocker that is commonly administered to prevent the incidence of PoAF. The systematic review below entails an analysis of six clinical trials that explore the effectiveness of metoprolol. The analysis identifies reduced hospitalization length, reduced mortality and reduced financial burden as the beneficial impact associated with the administration of prophylactic. The small number of studies reviewed limits the validity of the conclusion warranting future large sample size research.
Introduction
Annually, approximately 750,000 cardiac surgery are performed globally with postoperative atrial fibrillation (PoAF) being the prevalent complications (George, et al., 2018). With the increasing proportion of elderly population globally, it’s expected that…...

To the degree that nurses match their skills with patient's needs, thus is qualified nursing met (AACN, 2006).
From my experience, most surgeons, specifically in the cardiac ward focus on the minutiae of their skill and on saving the patient's life mo matter what. A failed surgery seems to them to cast aspersions on their skills. Dr. Agnihotri is, however, unique in that he places the patients needs first and foremost and ascertains that his assistants and interns do the same.

A case, at one time, for instance, that made ripples around the ward and impressed me intensely involved patient x who, at a great deal of pain and an advanced age with a surgery that seemed to promise only complications, just wanted to expire. Her family, however, endeavored to keep her alive, despite cost, level of pain, frequency, extension, and complications of surgery involved. Dr. Agnihotri focused on the needs…...

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References.

American Association of Critical-Care Nurses (AACN). (2006). The AACN Synergy Model for Patient Care. Retrieved April 3, 2011, from   opendocumenthttp://www.certcorp.org/certcorp/certcorp.nsf/vwdoc/SynModel ?

Hardin, S. (2005). Introduction to the AACN Synergy Model for Patient Care. In S.R. Hardin & R. Kaplow (Eds.), Synergy for clinical excellence: The AACN Synergy Model for Patient Care (pp. 3-10). Sudbury, MA: Jones and Bartlett Publishers.

Salmon, M. (2008). Cardiac Care Unit. Heart health Center. Retrieved April 3, 2011, from  http://heartdisease.about.com/lw/Health-Medicine/Conditions-and-diseases/Cardiac-Care-Unit.htm

The "pain" caused to the heart due to tissue damage can be misplaced in the body due to these nerve pathways and connections; heart attacks are often felt in the left arm and elsewhere on that side of the body between the heart and brain.
5)

Diuretics would encourage the elimination of sodium and a lessened fluid retention, easing the pressure in his arteries.

6)

The increased acidity in J.M.'s blood indicates reduced heart functionality and creatine phosphokinase levels are elevated which indicates muscle damage; low-normal lactate dehydrogenase suggest no recent prior infarctions, however, and without further tests this particular measure is not especially edifying.

7)

The drug relaxes blood vessels, allowing easier passage of blood reducing chest pain (which elevates stress and blood pressure) and easing the underlying problem, as well

8)

Aspirin inhibits the collection of platelets at the site of a plaque rupture, preventing a full blockage from building up and causing a heart…...

People die each year of cardiac related health problems. Some die of heart attacks and others of congestive heart failure and so forth. This research proposal highlights five peer reviewed journal articles that show how to improve, step-by-step, the infrastructure of a hospital cardiac program. Quantitative data from the studies along with in-hospital data will reveal the need for quality improvement as well as how successful certain methods are when implemented among specific populations. Information was gathered through the search engine Google Scholar and PubMed. All articles are less than four years old and reveal ways to not just improve the safety and care of patient's but also how to improve surgical outcomes and enhance IT infrastructure, all of which are essential to running a great hospital cardiac program.
Introduction

Several patients in (Hospital Name) have come in complaining of cardiac related health problems. Some have had issues with cardiothoracic surgery from…...

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References

Elliott, M.J. (2012). The role of information in ensuring quality and patient safety. Progress in Pediatric Cardiology, 33(1), 5-10. Retrieved from  http://www.sciencedirect.com/science/article/pii/S1058981311000853 

Grace, S.L., Poirier, P., Norris, C.M., Oakes, G.H., Somanader, D.S., & Suskin, N. (2014). Pan-Canadian Development of Cardiac Rehabilitation and Secondary Prevention Quality Indicators Endorsed by the Canadian Association of Cardiac Rehabilitation. Canadian Journal of Cardiology, 30(8), 945-948. Retrieved from  http://www.sciencedirect.com/science/article/pii/S0828282X14002335 

Guillamondegui, O.D., Gunter, O.L., Hines, L., Martin, B.J., Gibson, W., Clarke, C., Cecil, W.T. (2012). Using the National Surgical Quality Improvement Program and the Tennessee Surgical Quality Collaborative to Improve Surgical Outcomes. Journal of the American College of Surgeons, 214(4), 709-714. Retrieved from  http://www.sciencedirect.com/science/article/pii/S1072751511013287 

IEEE Conference on Software Engineering Education and Training, & IEEE Computer Society. (2011). Educating software engineers of the future: Software quality research through problem-based learning. In CSEE&T 2011: Proceedings (pp. 91-100). Los Alamitos, California: IEEE.

Interdisciplinary Care Providers CABG or coronary artery bypass graft surgery is advised for individuals suffering from CHD (coronary heart disease), for alleviating symptoms, prolonging lifespan, and improving QOL (quality of life) (Bayoumi, 2015). Improvements in mechanical ventilation-supported cardiac operation patient management continues to be a major focus area for better optimizing clinical results. The FTE (fast-track extubation) theory applied in case of cardiac operation patients is growing in popularity, in a bid to offer more economical and superior-quality healthcare. A large number of research works have established that prompt extubation (i.e., between 6 and 8 hours after surgery) may be a safe step, whilst decreasing admission and resource use expenses (Cheng, Karski & Peniston, 1996). In spite of the aforementioned advantages, prompt extubation is not consistently performed, underscoring the need to adopt a protocolized strategy for decreasing setbacks and variations and linked to weaning mechanical ventilation. Time-guided extubation protocols’ benefits have been adequately…...

Patient Education Decrease Anxiety Undergoing Invasive Cardiac Procedures
Annotated Bibliography

In this case, one of the main areas of topic is based on the role played by initial patient education on the anxiety of patients undergoing noninvasive cardiovascular surgery. It has been reported that the initial education provided by the nurses to the patient in relation to the noninvasive cardiac surgery helps the patient, as there is a great reduction in stress and level of anxiety in relation to the surgical procedures and the outcomes.

Riegel, B (ed). Journal of Cardiovascular Nursing. Philadelphia, U.S..

The journal is a complete online source for the information needed by the nurses in accordance to the procedures that can be used to reduce anxiety levels in the patients undergoing noninvasive cardiac surgery. These days it is important that the patients be taken into complete confidence by making sure they are aware of the procedures that they are going…...

Rossmond Jack for the Position of a First Assistant Surgical Technologist
I write to you in regards to the above applicant, Rossmund Jack. I recommend that you consider him for an entry-level position as a first assistant surgical technologist. Jack has the training, qualifications, and skills needed to effectively and efficiently undertake the role. He also has a strong passion for the field.

Jack will shortly be completing his surgical technologist degree at Mandl School's College of Allied Health; one of the top institutions in New York as far as allied health training is concerned. He has a solid understanding of the practical facets of surgical room procedures, modern surgical equipment, instrument set-ups, sterilisation techniques, patient-care techniques, as well as emergency care during surgery. His knowledge spans across a wide range of surgical disciplines including general surgery, orthopaedic surgery, spinal surgery, cardiac surgery, plastic surgery, thoracic surgery, and vascular surgery. He has…...

This is vital because medical personnel could administer something that causes life threatening symptoms if taken with an anticoagulant.
The final educational area that needs to be covered are the changes that must take place in the daily life of the patient. The patient must be careful not to cut himself or herself, In addition the patient must be careful not to take part in activities that might cause injury as injury can cause the patient to hemorrhage.

GI POBLEMS

Three common GI problems include heartburn, ulcers and irritable bowel syndrome. Each of these conditions can cause stomach upset. Heartburn can be treated with over the counter medications, including Zantac. Ulcers require a specific antibiotic and a stomach acid reducer and IBS is often treated with stomach acid reducers. In addition all three conditions respond favorably to changes in diet.

The medications for heartburn can be purchased over the counter, as can Zantac…...

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References

Precautions While Using This Medicine  http://www.healthopedia.com/drugs/detailed/anticoagulants/precautions.html# 

What is OxyContin?  http://www.drugfree.org/Portal/Drug_Guide/OxyContin

HEALTHCAE Healthcare: Cardiac Impact CAM PaperThe extensive use of Complementary and Alternative Medicine (CAM) has allowed the healthcare professional and the governmental bodies to re-think the strategies and policies that could offer a healthcare reform. It is of fundamental concern to comprehend what exactly comes under the definition of CAM. In the United States, CAM is interpreted to be an amalgamation of relaxation techniques, chiropractic, herbal treatment, and even including massage therapy (Institute of Medicine (US) Committee on the Use of Complementary and Alternative Medicine by the American Public, 2005). This paper investigates the use of CAM healthcare modalities, such as Ginseng, Hawthorn, L-Arginine, and St. Johns Wort that impact the cardiovascular system.GinsengEffect on Cardiovascular SystemThe cardiovascular system is adversely affected when diseases like hypertension, dyslipidemia, peripheral vascular disease, and coronary artery disease are endured by the patient regardless of gender (Kim, 2012). The most common form of ginseng for…...

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Rabito, M.J. & Kaye, A.D. (2013). Complementary and alternative medicine and cardiovascular disease: An evidence-based review. Evidence-Based Complementary and Alternative Medicine, 2013.   S.P., Becker, L.C., Kass, D.A., Champion, H.C., Terrin, M.L., Forman, S., Ernst, K.V., Kelemen, M.D., Townsend, S.N., Capriotti, A., Hare, J.M. & Gerstenblith, G. (2006). L-arginine therapy in acute myocardial infarction: The vascular interaction with age in myocardial infarction (VINTAGE MI) randomized clinical trial. JAMA Network, 295(1), 58-64.  https://doi.org/10.1001/jama.295.1.58 Shaito, A., Thuan, D.T.B., Phu, H.T., Nguyen, T.H.D., Hasan, H., Halabi, S., Abdelhady, S., Nasralla, Eid, A.H. & Pintus, G. (2020). Herbal medicine for cardiovascular diseases: Efficacy, mechanism, and safety. Frontiers in Pharmacology, 11.   https://doi.org/10.3389/fphar.2020.00422  Tassell, M. C., Kingston, R., Gilroy, D., Lehane, M., & Furey, A. (2010). Hawthorn (Crataegus spp.) in the treatment of cardiovascular disease. Pharmacognosy Reviews, 4(7), 32–41.  https://doi.org/10.4103/0973-7847.65324https://doi.org/10.1155/2013/672097Schulman,

The procedure itself and the hospital stay associated with it is only one small chapter in the patient's life. They will eventually go home and will have many years after the procedure. It is important for the nursing staff to make a positive impact on how they feel about the procedure. The procedure will represent a lasting memory to the patient. If the patient perceives this to be a time of strength and care from nurturing individuals then it will help them to be able to develop the coping mechanisms necessary to learn to live with the after-effects of the procedure.
If the patient sees this as a negative experience, then it could produce unwanted effects such as depression, post-traumatic stress disorder, or other emotional problems that could have an effect on their ability to cope with the life changes. Those that develop appropriate coping mechanisms will be more likely…...

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References

Knoll, N., Rieckmann, N., & Schwarzer, R. (2005). Coping as a mediator between personality and stress outcomes: A longitudinal study with cataract surgery patients. European Journal of Personality, 19, 229-247.

Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2004). Initiation and maintenance of physical exercise: Stage-specific effects of a planning intervention. Research in Sports Medicine, 12, 221-240.

Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2004). Behavioral intentions and action plans promote physical exercise: A longitudinal study with orthopedic rehabilitation patients. Journal of Sport & Exercise Psychology, 26, 470-483.

Lippke, S., Ziegelmann, J.P., & Schwarzer, R. (2005). Stage-specific adoption and maintenance of physical activity: Testing a three-stage model. Psychology of Sport & Exercise, 6, 585-603.

Congestive Cardiac Failure: Nursing Perspective
Congestive heart failure is a congenital condition that affects millions of American's every year. Heart failure often manifests in a chronic condition for victims of the disease.

There are several nursing interventions important for control and maintenance of the condition. Congestive heart failure can result in serious complications including edema, respiratory disorders and can lead to premature death. Treating congestive heart failure appropriately is critical to a patient's outcome. Perhaps even more critical to a patient's outcome is patient education targeted at prevention and healthy living. Nursing management of the condition depends upon appropriate medical evaluation, medication administration, monitoring and patient education. These ideas are explored in greater detail below.

Congestive heart failure is often congenital in nature. Congestive heart failure usually manifests when the cardiac muscle is old and tired and stops circulating properly. This may result from damage to the heart; alternatively myocarditis and cardio…...

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References

AMA. (2004). "Congestive Heart Failure." American Heart Association, Inc. {Online} Available:  http://www.americanheart.org/presenter.jhtml?identifier=4585 

Adomeit, A; Baur, A; Salfeld, R. (2001). "A New Model for Disease Management." The McKinsey Quarterly.

Antoni, M; Ironson, G; Saab, P; Schneiderman, N. (2001). "HEALTH PSYCHOLOGY: Psychosocial and Biobehavioral Aspects of Chronic Disease Management." Annual Review of Psychology

Arocha, J; Patel, V. (1995). "Novice Diagnostic Reasoning in Medicine: Accounting for Evidence." Journal of the Learning Sciences, Vol. 4

Implantable Cardiac Devices
Heart disease remains one of the leading causes of death in the United States but there are a number of different implantable cardiac devices (ICDs) available today, including pacemakers, defibrillators and cardiac resynchronization devices, that can help people with heart disease or failure go on to lead normal lives by regulating their heart beats through a series of electric shocks. To determine the facts about these devices, this paper provides a review of the literature to explain the respective indications for these devices as well as their differences. Finally, a summary of the research and important findings concerning these implantable cardiac devices are provided in the conclusion.

eview and Discussion

Indications for each of the following: Pacemaker, ICD (defibrillator) & Cardiac esynchronization Devices

Pacemaker. According to Gregoratos et al. (1), this type of ICD is indicated for patients suffering from abnormalities of atrioventricular (AV) conduction which may be asymptomatic; however,…...

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References

1. Gregoratos, G et al. American Heart Association [Internet] ACC/AHA Practice Guidelines 2016 [cited 2016 April 26] Available from  http://circ.ahajournals.org/content/97/13/1325.full .

2. American Heart Association. [Internet] What is a pacemaker. 2016 [cited 2016 April 26] Available from   / downloadable/ucm_300451.pdf.https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents 

3. Perry, P ICD -- The Beat Goes On: Experts Call for Expanded Coverage of ICDs, the Most Effective Method to Date for Preventing Sudden Cardiac Death in High-Risk Coronary Patients. The Saturday Evening Post 2004, March-April 276(2): 28-29.

4. Medtronic [Internet] 2012 ACCF/AHA/HRS Guidelines for Implantable Defibrillator and Cardiac Resynchronization Therapy for Cardiac Rhythm Abnormalities. 2012. [cited 2016 April 26] Available from   / documents/2012-accf-aha-hrs-guidelines.pdf.http://www.medtronic.com/content/dam/medtronic-com-m/mdt/crdm 

Maxton, F.J.C., Justin, L. & Gillies, D. (2004). Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. Journal of Advanced Nursing 45(2): 214-22.
What is the research question? If it is not explicitly written, but is implicit in the article, suggest null and alternative hypotheses.

Which temperature-taking site yields the most accurate readings in babies and young children following cardiac surgery? Temperature is usually measured using the pulmonary artery as a "gold standard." However, the authors hypothesize that because the pulmonary artery cannot be used in the majority of the patients in the target population, other methods can and should be used. In addition to pulmonary artery temperature, the temperatures can be taken at the rectal, bladder, nasopharyngeal, axillary, and tympanic sites.

List the variables used in the study and identify each of them as either independent or dependent variables. Also describe the level or scale of…...

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References

Maxton, F.J.C., Justin, L. & Gillies, D. (2004). Estimating core temperature in infants and children after cardiac surgery: a comparison of six methods. Journal of Advanced Nursing 45(2): 214-22.

internal validity and external validity are important when designing, implementing, and reviewing empirical research. Internal validity refers to the design of the research and its methodology. Issues like sampling, statistical analyses, robustness of the variables, survey instruments, and researcher bias can impact internal validity. With regards to my research question, internal validity is of the utmost importance. The independent variables in this case include two different types of interventions: bloodless cardiac surgeries and blood transfusions. However, it is important to operationalize these two independent variables so that the researchers are clear on what exactly constitutes a bloodless surgery and a blood transfusion. Moreover, issues like hospital setting must be taken into account as a potentially confounding variable. When, where, and how these procedures are implemented can all have a bearing on the internal validity of the research design.
Likewise, the dependent variables are morbidity and mortality in patients. It is…...

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References

"Internal Validity," (n.d.). Retrieved online:  http://www.indiana.edu/~p1013447/dictionary/int_val.htm 

Osborn, D.R. (n.d.). External validity. Retrieved online: http://cas.bellarmine.edu/Osborn/hypertut_piv/external_validity_is_concerned_w.htm

Shander, A., Moskowitz, D. & Rijhwani, T.S. (2005). The safety and efficacy of 'bloodless' cardiac surgery. Seminars in Cardiothoracic and Vascular Anesthesia 9(1).

Whitson, B.A., Huddleston, S.J., Savik, K. & Shumway, S.J. (2007). Bloodless cardiac surgery is associated with decreased morbidity and mortality. Journal of Cardiac Surgery 22(5): 373-8.

Advancements in technology have greatly improved outcomes in cardiac surgery in a number of ways:

1. Minimally invasive techniques: Technology has allowed for the development of minimally invasive procedures, such as robotic-assisted surgery, which reduce the size and number of incisions needed for surgery. This results in less trauma to the body, quicker recovery times, and lower rates of complications.

2. Imaging technology: 3D imaging techniques, such as CT scans and MRI, provide surgeons with detailed views of the heart and surrounding structures, allowing for more precise planning and execution of surgery.

3. Surgical tools: Advancements in surgical tools, such as high-resolution cameras,....

Advancements in Technology and their Impact on Cardiac Surgery Outcomes

Introduction:
Cardiac surgery, once a highly invasive and risky procedure, has undergone a transformative evolution due to technological advancements. These innovations have significantly enhanced patient outcomes, reduced complications, and improved the overall quality of life for those undergoing cardiac surgery.

Minimally Invasive Techniques:

Robotic Surgery: Robotic systems provide surgeons with enhanced precision and dexterity, enabling them to perform complex operations through small incisions. This results in less scarring, reduced pain, and faster recovery times.
Endoscopic Surgery: Endoscopes allow surgeons to access the heart through natural orifices or small incisions. This approach minimizes tissue....