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Controversies in patient management after cardiac surgery.

The cardiovascular surgical patient presents great challenges in terms of patient management. As the specialty has grown since its earlier days, so have the strategies for patient management and related nursing practice. This article examines four controversial topics related to postoperative management of these patients: treatment for atrial fibrillation, antithrombotic therapy, replacement fluid management, and issues related to advanced nursing practice. Three of these topics, although having a medical focus, augment the nursing knowledgebase and provide assistance in independent decision making. The fourth topic reviews issues related to extended practice within the staff nurse role.