Unit 12 Discussion Impulsivity and Compulsivity. 800w. 4 references. Due 11-13-23.

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Unit 12 Discussion Impulsivity and Compulsivity. 800w. 4 references. Due 11-13-23.

1. Please describe the role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. 

2. Please provide two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. 

3. Summarize the following article “Behavioral Functions of the Mesolimbic Dopaminergic System: an Affective Neuroethological Perspective” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2238694/

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

1. Role of the mesolimbic dopamine pathway in the development or continuation of impulsive/compulsive behaviors. The mesolimbic pathway is the dopamine pathway. This pathway extends from the “VTA of the brainstem (mesencephalon) to the nucleus accumbens in the ventral striatum which is part of the limbic system (Stahl, 2021, p. 90). This pathway is important as it is involved in the regulating motivation and reward. Hyperactivity of the mesolimbic pathway called hyperdopaminergia, is significant in the display of positive symptoms seen in psychosis, schizophrenia, and depression and can result in impulse, agitation, hostile, and aggressive symptoms. In addition, the hyperactivity of the DA pathway can be because of various psychostimulants. Such as, cocaine and methamphetamine (Stahl, 2021, p.90). In terms of impulsivity and compulsivity Stahl (2020, p.541) states, “Impulsivity can be thought of as the inability to stop the initiation of actions and involves a brain circuit centered on the ventral striatum, linked to the thalamus (T), to the ventromedial prefrontal cortex (VMPFC), and to the anterior cingulate cortex (ACC). Compulsivity can be thought of as the inability to terminate ongoing actions and hypothetically is centered on a different brain circuit, namely the dorsal striatum, thalamus (T), and orbitofrontal cortex (OFC). Impulsive acts such as drug use, gambling, and obesity can eventually become compulsive due to neuroplastic changes that engage the dorsal habit system and theoretically cause impulses in the ventral loop to migrate to the dorsal loop.” 2. Two examples of current research on interventions to reduce or eliminate compulsive/impulsive behavior related to addiction. According to Hartney (2021), compulsions are considered obsessions with repeated thoughts that create a feeling of distress (Hartley, 2021). The person’s behavior reduces anxiety and fear. An example to consider is obsessive compulsive disorder. In this disorder, the obsession revolves around the need to wash their hands. In the case of addiction, the desire to use will far outweigh the reality that there may be negative consequences. Such as financial strains, health issues, social problems, legal problems and/or decreased self-esteem (Hartney, 2021). Hartney (2021), suggests for treatment of the OCD behavior should include antidepressant medications like serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). These medications may be augmented with antipsychotics at the discretion of the provider. In terms of impulsivity, Kozak and her colleagues (2018) denote there are strong overlaps in the neural circuitry and functional mechanisms between impulsivity traits and addiction, which has directed treatment approaches. Therefore, it has been recommended, SUD treatment should include subjective and objective data and target the pharmacological, behavioral, and neurophysiological areas to individualize the patient’s care (Kozak et al., 2018). This study source was downloaded by 100000769192234 from CourseHero.com on 10-22-2023 17:11:39 GMT -05:00 https://www.coursehero.com/file/139195954/Discussion-12-ImpulsivityCompulsivitydocx/ For example: Alcohol use disorder – Naltrexone, Aripiprazole, and Topiramate were successful in decreasing impulsivity behaviors and Problem gambling – paroxetine was found to be successful in impulsivity (Kozak et al., 2018). References: Hartney, E. (2021). The difference between an addiction and a compulsion. Retrieved on March 30, 2022, from https://www.verywellmind.com/the-difference-between-an-addiction-and-acompulsion-22240 Kozak, K., Lucatch, A. M., Lowe, D., Balodis, I. M., MacKillop, J., & George, T. P. (2019). The neurobiology of impulsivity and substance use disorders: implications for treatment. Annals of the New York Academy of Sciences, 1451(1), 71–91. https://doi.org/10.1111/nyas.13977 Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.). p. 90 & 54, Cambridge: Cambridge University Press.

DUE REAL 1

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Name: Linda McCarthy
Age: 86 years
Provider: K. Townsend MD
Codestatus: DNI
BMI: 24.1
Allergies: penicillin, atorvastatin, red dye, latex
Admitweight: 145 lbs (65.8kg)

Linda McCartchy had a rough night. She was pretty restless and only slept two hours.
This morning she was having an issue with her hearing aids not working. They kept
whistling. I went to change the batteries, but she was out of them. Her family will be
bringing them in later today.

Nursing Assessments and notes

11/1
0700

Neuro/Cognitive: Alert and oriented to person and place. She intermittently
confused and called staff by the names of her children. Speech raspy. 4/5
strength in all extremities.
Cardiovascular: S1 and S2 heart sound present. Heart rate regular and even.
No edema was noted. Pedal pulses +2, radial pulses +3. Capillary refill less
than 3 seconds.

Respiratory: Even, regular, unlabored. Lung sounds wheezing through all
lung fields. Chronic dry cough. Wears 2 L via nasal cannula chronically.

Gastrointestinal: BS present x 4 quadrants. Abdomen soft, non-distended,
non-tender. Last bowel movement 2 days ago.

Genitourinary: Occasional stress incontinence.

Integumentary: Scattered bruising. Various stages of healing.

Sensory: Hard of hearing. Wears hearing aids and glasses.

11/1
0730

ADLs: Independent with utensil holders
Activity: Ambulated 100 feet with a roller walker

11/1
0830

Nursing Note: Client resting quietly in bed. Looking out the window, not
responding to staff prompts for verbal interaction. Moves all extremities
appropriately. Morning medications were administered without difficulty. Able
to state name but unsure of her birthday. Up in the hall with physical therapy.
Shuffling gait with use of a rolling walker.

11/1
1100

Nursing Note: RN called to bedside. The client stated that the staff took her
favorite earrings. Earrings were found in the client’s tissue box at the bedside.

11/1
2015

Nursing Note: Client evening hygiene offered. The client begins yelling, “No!
No! No!” as staff offer to assist with teeth brushing and denture care. Attempts
were made to deescalate the client and place her hearing aids so that she
could hear the conversation. The client begins attempting to hit and bite staff.
Client sitting in bed. Staff leave room to reduce stimulation.

11/1
2015

Neuro/Cognitive: Alert, oriented to self only. She believes it is 1965 and that
there are strangers in her house. Client calling out for her mother. Extremely
hard of hearing with hearing aids in place.

11/2
0700

Nursing Note: The client is awake in bed, staring around her room, rubbing
her eyes, and frequently yawning. Noted to have redness and purulent
drainage from right eye. Provider notified; prescriptions received.

11/2
0900

Nursing Note: Appetite poor, ate 5 small bites only, Drank a cup of juice.
Weight down. Will encourage protein supplement drinks between meals.

Date Intake Source & Amount

11/1 0700 Oral 240 mL

11/1
0900

Client Information:
Medical History: Presbyopia, bilateral cataracts, Alzheimer’s dementia,
hearing loss, hypertension, hyperlipidemia, osteoarthritis, ambulatory
dysfunction, chronic obstructive pulmonary disease

Medications:
● Rivastigmine 6 mg by mouth twice daily
● Lisinopril 20 mg by mouth daily
● Ezetimibe 10 mg by mouth daily
● Simvastatin 40 mg by mouth daily
● Docusate sodium 100 mg by mouth daily
● Polyethylene glycol 17 g by mouth daily – diluted in 8 oz of beverage
● Duloxetine 60 mg by mouth daily
● Artificial tears 1-2 drops into eyes PRN for dry eyes
● Oxygen 2L/NC PRN for difficulty breathing

11/2 0730 Prescriptions:
● Ciprofloxacin ocular ointment 0.5-inch right eye three times

daily

Please Reply to the following 2 Discussion posts

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Please see the attachment for instructions

poster project

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virtual poster.

Writing

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1st 

 

The Theory of Goal Attainment and Transactional process is a theory that guides nurses to practice nursing based on a personal approach. It is a Grand Theory based on Interactive Process.  The purpose of this theory is to be able to achieve patients’ goals by forming a relationship with the client or patient. To be able to form a relationship with a patient/client there are several factors that have to be consider.  One of the main factors that has to be consider is the fact that the patient is a unique individual and as such nurses must think how to approach this patient to form a therapeutic relationship that will involve the patient in his/her own healthcare goals.

The goal of attainment has impacted research, education, and the nursing. However, it has impacted nursing education in particular. “For example, it served as a frame work for the baccalaureate program at the Ohio State University School of Nursing where it determined the content and process taught at each level of the program” (McEwen & Wills,2023, p. 177).

The development of this theory was created by Imogene King in the 1960’s.  “During this time nursing practice was not so much based on theory.  Nursing practice was generally prescribed by others and highlighted by traditional, ritualistic tasks with little regard to rational” (McEwen & Wills, 2023, p.25).

It is interesting to know that this theory has been used not only for the purpose of education, research and nursing practice but it has also help to develop other theories.   “In addition to application in practice and research described previously, King’s work has been the basis for development of several middle-range nursing theories.  For example, was used by Rooda (1992)  to develop a model for multicultural nursing practice” (McEwen & Wills, 2023, p. 117)> 

2nd 

Virginia Henderson was born in Missouri and raised in Virginia. She grew up to receive her diploma in nursing from the Amy School of Nursing located at Walter Reed Hospital. Within two years of working as a bedside nurse her passion for the profession grew immensely.  She applied to and was offered a nurse educator position at a hospital in Virginia. From that day Henderson embarked on a lifelong mission to educate nurses on her concept of the nursing profession. Over a decade she had  went on to obtain her Bachelors of Nursing degree in 1932 and her Master’s degree in 1934. Her concept and theories evolved and was imitative of her passion, practice and education. 

The philosophical and structural components of her theory was focused on educating nurses and providing patient care in an encouraging environment. Henderson was introduced to physiologic principles during her graduate education. The study of these principles was the fundamental basis of her framework for patient care (Henderson, 1965, 1991). The physiologic principle implies that the patient’s biology, psychology and sociology (biopsychosocial) all had to be taken into consideration when providing care. As her studies and work experience progressed, she was also introduced to “Thorndike’s fundamental needs of a man” (McEwen, Grand Nursing Theories Based on Human Needs 2022), in which she gave credit to as having a direct influence on her beliefs. Another major concept of her theory is that nurses should assist patients with otherwise daily activities of life in times of illness until the patient is back to their optimistic level of health. Overall, helping the patient to regain independence by providing a supportive environment. Her concept of nursing included the nurse assisting the patient with 14 activities.

Henderson’s theory of nursing has immensely affected nursing education, nursing research and nursing practice.  Lucier (2018), for example, described how Henderson’s model could be used to enhance the nurse−patient relationship to provide holistic care at the end of life. Similarly, Waller-Wise (2013) found that Henderson’s theory assisted nurses in attaining excellence in childbirth education, and Miranda et al. (2018) used Henderson’s assumptions and model in their analysis of the concept of “nursing care of overweight children.” (McEwen, Grand Nursing Theories Based on Human Needs 2022). Her contribution to nursing textbooks extended from 1930-1990’s. Her contributions to nursing had a global impact by strengthening the focus on nursing practice and confirming the value of tested interventions in assisting individuals to regain health (McEwen, Grand Nursing Theories Based on Human Needs 2022). Researchers internationally continue to be influenced by Henderson’s model as a framework.

Rubric

 

 

Criteria for Grading Discussion Participation
Interactions should be thorough, thoughtful and facilitate the learning community’s growth.
Behaviors will be reviewed on a weekly basis. Contribution toward the course grade total
will be based on the pattern of demonstrating these characteristics.
Please remember, initial posts should be submitted by midnight by deadline. Your
responses to two of your peers’ initial posts should be made by deadlines, and then
responses to questions or comments made to you on your posts or discussion responses
should be made by deadlines also, per syllabus above.
Rubric for evaluating Discussion Participation
Characteristic of the Response Point Value
 No response 0
 Responses are noncontributory (e.g., “I agree with the comment;”
“I was thinking the same thing:” “I had a similar experience.”
2
 On-time response to all points
 Response is not relevant to other statements or the discussion
thesis
 Response shows minimal understanding of the topic
4
 On-time response to all discussion points
 Response reflects the point being discussed; builds on ideas of
other participants
 Facts and examples are appropriate to each thesis and are
accurate
 Rules of communication, language, etc. are utilized so as not to
distract the flow of discussion
6
 All elements in the 6-point division (above) and
 Responses reflect complete understanding of topic and assigned
readings
 Uses greater detail, examples and other sources to support
discussion
 Initiates another question (which may/may not be discussed by
group0
8
 All elements in the 8-point division (above) and
 Analyses, discussions and conclusions explicitly linked to the
10

 

Nutritional Principles in Nursing

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Describing a Nutritional Assessment Tool

Module 05 Content

Find a dietary assessment tool that can be used either generally or for a specific alteration in health.


When you have found your assessment tool, answer the following questions:

What is the purpose of this tool?

Do you believe that the purpose is fulfilled based on the questions being asked? Why?

In what ways does the tool account for the individual perceptions and needs of the client?

Is there a nutritional history included? What does it cover?

Is the tool easy to use? Why or why not?

Does the tool provide enough information to determine next steps or interventions? Explain.

The writing assignment should be no more than 2 pages and APA Editorial Format must be used for citations and references used. Attach a copy of the assessment tool.

2nd Response to disc 7

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PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:

Barrier #2; Nurses are not visible in healthcare policy making. 

According to Anders (2021), nurses are professionals who are directly involved in patient care. Engagement front line nurses have with patients, and other healthcare professionals, make them ideal healthcare policy advocates. They have appropriate academic education and clinical expertise to serve as experts in sharing their knowledge with policymakers and others. Any other profession cannot replicate the situational knowledge of the healthcare needs of patients that this large workforce offers.  

However, nurses’ access to policy-making processes is limited. The author supports the concept of barrier by explaining that despite nursing’s intrinsic involvement in the advocacy of the individual patient, the nursing voice is often not heard at a public level. Since nurses represent approximately 50% of the global health workforce, they should be actively involved in policy-making processes. However, nursing representation at the government and boardroom level is still slim (Anders, 2021).  

The author suggests how nurses can participate in policy development. Meaningful policy change can occur at the institutional level, where nurses are accustomed to functioning. Nurses’ involvement in self‐governance within hospitals presents opportunities for staff nurses to participate in the clinical governance at a local level. Nurses can also begin as a member contributing to online discussions, blogs, or social media interest groups sponsored by the association, then progress to active participation in any number of subcommittees, and finally run for office. 

                          References  

Anders R. L. (2021). Engaging nurses in health policy in the era of COVID-19. National Library of Medicine 56(1), 89–94. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7675349/Links to an external site.  

Nursing NUR 445 Week 7 Assignment: Theory Assignment Submission

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This week, you will select Lewin’s change theory or the PDCA that would work best for your proposed quality improvement project. you will need to summarize the main theoretical notions and concepts of the selected theory. You will then need to discuss in detail the various stages of implementation of the proposed project based on the selected theory.

Quality/performance improvement (QI/PI) frameworks

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Develop a 4-page quality/performance improvement framework for your doctoral project.

Quality/performance improvement (QI/PI) frameworks are used to establish and evaluate processes in practice. The most common models for such a framework are Plan-Do-Study-Act (PDSA) and Six Sigma Define, Measure, Analyze, Improve, Control (DMAIC). The purpose of this assessment is to use key information from your project charter to develop a QI/PI framework from which you will begin developing a project implementation plan and logic model in the next assessment.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

· Competency 1: Align the project charter with a continuous improvement model.

1. Describe the current practice needing improvement.

1. Explain how QI/PI data will be collected and analyzed.

1. Describe the proposed QI/PI changes and expected outcomes.

1. Explain how changes in quality or performance will be evaluated.

1. Apply APA style and formatting to scholarly writing.

Instructions

Is about reducing falls in a primary care clinic with the implementation of a fall risk management protocol, now the clinic doesn’t use any protocol.

Develop a quality/performance improvement (QI/PI) framework for your project, aligned with your project charter. Choose a model for your framework, using the PDCA or DMAIC model, a model used in your organization, or another familiar reputable model that is suitable for your project. PDCA or DMAIC model information and examples are included in Resources.

Provide a succinct, scholarly narrative that reflects the content of your model and addresses the key points outlined below:

Graded Requirements

Each of the main tasks corresponds to scoring guide criteria. Read the performance-level descriptions in the scoring guide for each criterion to see how your work will be assessed.

· Describe the current practice needing improvement.

1. What is the problem and its root cause?

1. What is the gap between what is and what should be?

1. What evidence supports your assertions and conclusions?

· Describes a QI/QP framework that will support and guide the project.

2. What do you need to accomplish to meet the project objectives and outcomes?

2. What formative assessments will help you ensure that the project is on course?

2. Which framework will assist you in guiding the entire project?

· Explain how QI/PI data will be collected and analyzed.

3. What data is needed?

3. How will you record and organize collected data?

3. What are appropriate data analysis methods for the type of data you will be collecting?

· Describe proposed QI/PI changes and expected outcomes.

4. What are appropriate measures for determining actual improvement?

4. How feasible are the proposed changes and what are the relevant contextual factors that can affect expected outcomes?

· Explain how changes in quality or performance will be evaluated.

5. What evaluation tools or methods will you use?

5. What criteria will you use to evaluate outcomes?

· Write clearly and concisely in a logically coherent and appropriate form and style.

6. Write with a specific purpose and audience in mind.

6. Adhere to scholarly and disciplinary writing standards.

6. Proofread your writing to minimize errors that could distract readers and make it difficult for them to focus on the substance of your introduction.

· Apply APA style and formatting to scholarly writing.