Order type: AssignmentSubject: NursingAcademic level: MasterStyle: APA
Unit 4 – MN504Assignment DetailsInterpreting Statistical Output for Data Analysis PowerPoint PresentationPurpose:The purpose of this Assignment is to enable you to present the information that you gather from a systematic review on your PICOT topic. This activity will give you the experience to present what your research findings to others.Directions:1. Define the clinical key questions based on PICOT.2. Briefly review the database selected for key clinical questions.3. Identify the studies of the database search that are a Level I or II evidence. (Level I: Evidence from a systematic review of all relevant randomized controlled trials (RCT’s), or evidence-based clinical practice guidelines based on systematic reviews of RCT’sLevel II: Evidence obtained from at least one well-designed Randomized Controlled Trial (RCT))4. Interpret the statistical results of the studies identified in Step 3.5. Design a presentation.a. Place results /overview of research in PowerPoint.b. Length of the presentation should be 12–15 slides.6. Follow APA format.To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.Assignment Requirements:Before finalizing your work, you should:• be sure to read the Assignment description carefully (as displayed above)• consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary;• utilize spelling and grammar check to minimize errors; andYour writing Assignment should:• follow the conventions of Standard American English (correct grammar, punctuation, etc.);• be well ordered, logical, and unified, as well as original and insightful;• display superior content, organization, style, and mechanics; and;• use APA 6th edition formatMy PICOT is in the paper below:Comparison of the Effects of Beta- Blockers and ACE Inhibitors in Reducing Blood Pressure among Post- Cardiac Surgery Patients during RecuperationIntroductionBeta-blockers are antagonists that inhibit the receptor sites for catecholamines such as epinephrine and norepinephrine on adrenergic beta-receptors in the sympathetic nervous system (Akbar & Alorainy, 2014). Angiotensin-converting enzymes (ACE) inhibitors are a group of medications that prevent the production of the Angiotensin II hormone (Ong, Ong & Ho, 2013). The cardiovascular medications are clinically used to treat hypertension as well as the management of cardiovascular disorders such as myocardial infarction, heart arrhythmias, and ischemic heart diseases.Research QuestionWhat are the effects of Beta-blockers and ACE inhibitors on blood pressure in older patients who have undergone cardiac surgery?P- (Patient/Population) – The target population comprises of older patients (aged 65 years and above and those who have undergone cardiac surgery.I- (Intervention) – Beta-blockers. The control of blood pressure in post cardiac surgery patients is important to reduce the development of fatal cardiac conditions such as arrhythmias and myocardial infarction. The use of right medications and doses in the patients prevents the development of the negative effects and increases their effectiveness.C- (Comparison) – Using ACE inhibitors. The medications inhibit the production of Angiotensin II hormone, which constricts blood vessels. Unlike beta-blockers, they are linked to the development of kidney disorders and are not recommended in angioedema and renal artery stenosis patients. Besides, they have to be combined with diuretics for better results, unlike beta-blockers that can be used alone.O- (Outcome) – a reduction of blood pressure in post- cardiac surgery patients and the development of adverse cardiac conditions after their use.T- (Time) -Database: Cochrane Database.Search Terms: “Beta blockers in cardiac patients” “ACE inhibitors in cardiac patients.”The articles used are systematic reviews and therefore, present a high level of evidence to inform current practice.Literature ReviewFour studies were selected for review. They are works by Blessberger et al. (2014), Muller et al., (2000), Lane & Lip (2000) and Taverny et al. (2016).Blessberger et al. (2014) carried out a systematic review to analyze the effectiveness of particular groups of drugs in the prevention of cardiac surgery-related mortality and morbidity. They reviewed 53 trials of post- cardiac surgery patients and 89 randomized trials of other types of operations. The researchers concluded that the use of beta blockers in the management of hypertension in post cardiac surgery patients was more beneficial than in their use to lower blood pressure in non- cardiac related heart surgeries and were more helpful than other medications (Blessberger et al., 2014). They note that in the post- cardiac surgery recuperating patients, beta-blockers prevent the development of heart arrhythmias, sudden heart attacks, strokes and the development of low blood pressure (Blessberger et al., 2014). The research indicates that beta-blockers have significant effects to post cardiac surgery patients more than other medications which were compared in the study.Muller et al., (2000), carried out a similar study that focused on the use of Angiotensin Converting Enzyme (ACE) inhibitors to reduce blood pressure among post- operative cardiac patients. Notably, the patients in the study did not have any significant differences in their diastolic arterial pressure, their heart rates or the cardiac indexes. On the contrary, patients in one group had a significant difference with patients in other groups. Muller et al. concluded that the angiotensin converting enzyme inhibitor drug reduced the incidence of postoperative hypertension. The study is of significance to this research as it indicates that in post cardiac operative patients, the use of ACE inhibitors did not have other positive effects other than the control of blood pressure, unlike the use of beta-blockers.Lane and Lip carried out a study to determine the effects of pressure-lowering medications among patients with hypertension and symptomatic peripheral arterial disease (2013). They conducted a systematic review of articles from the Cochrane database and the selection criteria used was of symptomatic patients and those who had undergone peripheral arterial disease surgery at least one month earlier. In a comparison of the effects of ACE inhibitors against a placebo in patients, they noted that in addition to a drop in the blood pressure of the patients, there was a decline in the prevalence of cardiovascular events. However, an evaluation of the effects of beta- blockers on peripheral arterial disorder patients after surgery did not indicate any significant variations in their results against placebos (Lane & Lip, 2013). The beta-blockers reduced the number of heart attacks, atrial fibrillation, stroke and myocardial infarction. The significance of the study by Lane and Lip to this research is that it concludes that both types of medications have positive effects to post- cardiac surgery patients, although beta blockers have more effects than ACE inhibitors.Taverny et al. assessed the effects of common antihypertensive pharmacotherapies in the prevention of sudden death among hypertensive individuals with cardiac disorders indicated that the drugs control hypertension in the patients (2016). Their selection criteria were randomized trials in which any of the antihypertensive drugs including ACE inhibitors and beta-blockers. Also, the patients who were subjected to the trials had to have a resting systolic blood pressure of at least 140mmHG and/ or a resting diastolic pressure of at least 90mmHg (Taverny et al., 2016). The comparisons in the trials were made against placebos. From the results they obtained, the researchers concluded that the use of all types of antihypertensive drugs prevented the development of sudden death among cardiac patients by reducing the incidence of myocardial infarction. ACE inhibitors and beta blockers are common antihypertensive drugs which are used for the control and management of hypertension in cardiac patients, and the research indicates that they all reduce the susceptibility of one to develop fatal cardiac conditions.ConclusionThe literature review above indicates that ACE inhibitor and beta blocking medications play a significant role in reducing hypertension in post-cardiac surgery patients. While ACE inhibitors work by preventing the production of Angiotensin II hormone, which constricts the blood vessels and leads to an increase in blood pressure, the beta-blockers prevent the activation of receptor sites for catecholamines in the nervous system. Also, both classes of drugs impede the development of fatal cardiac conditions such as heart arrhythmias and myocardial infarction, although beta blockers have more positive effects than ACE inhibitors. However, there is no significant difference in their effectiveness against hypertension in post-cardiac surgery patients. Generalization to patients should be careful while considering the health care setting.?