nursing leadership and management.

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How has nursing practice evolved over time? Explain the significance of evidence-based practice and critical thinking in modern nursing. Identify one key nursing leader and summarize one historical event that has shaped contemporary nursing practice, the advancement of nursing as a profession, and the development of nursing roles. Select a leader and a historical event different from those identified by your classmates.

minimum of 300 words and include at least two references cited using APA format.

nur 502- week 3 -1

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nur 502 week 3 -2

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case study week 4

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please see attachment

RWH see below

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RWH see below

PTSD

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See attached doc 

Discussion P W3 Reply 1-1

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Anterior and posterior are the two lobes of the pituitary gland, which is located in the bony sella turcica, is attached to the base of the brain and has a unique connection with the hypothalamus. The pituitary gland consists of two anatomically and functionally distinct regions, the anterior lobe (adenohypophysis) and the posterior lobe (neurohypophysis). Between these lobes lies a small region called the intermediate lobe. The hypothalamus regulates the pituitary gland secretion (Sayed, 2023). The anterior pituitary hormones (AP) are responsible for the growth hormone (GH), other names this hormone is known as is somatotropic hormone or somatotropin and it targets most of all tissues in the body. The transport mechanism consists of 60% circulates free and 40% bound to specific GH-binding proteins (GHBPs) (Sayed, 2023), and it causes the GH to bind to growth hormone receptors (GHR) and activates the growth process in the body. GH also have direct metabolic functions, such as stimulation the growth of all tissues of the body by increasing the number of cell and effects fats, proteins and carbohydrates. Indirect actions on the skeletal system consist in skeletal growth by stimulating production of IGF-1 from hepatocytes (Sayed, 2023). In other words, GH targets the bones and skeletal muscles. The anterior pituitary gland is regulated through vessels that connect to the hypothalamus and posterior pituitary gland is regaled by nerves connected to the hypothalamus, both are an essential part to our system.

The pituitary glands and hypothalamus are vulnerable to head trauma, face trauma, as well as lack blood supply such as cardiac arrest. Evaluation and treatment of individuals with hormonal deficiency post a traumatic brain injury (TBI) can be challenging. The prevalence of pituitary abnormalities after TBI varies greatly across research studies, from a mere 1% to three-quarters of TBI patients being reported as potentially affected! (Sandel, 2022). Acute TBI may resolve however other deficiencies may become chronic and may have a greater impact on the cognitive skills affection the host. According to researcher Dr. Elizabeth Sandel that approximately one-third of TBI patients have persistent anterior pituitary dysfunction 12 months or more following the injury (Sandel, 2022). Furthermore, many acute abnormalities can be life-threatening. Some examples of abnormalities in the posterior pituitary are the result of too much or too little anti-diuretic hormone (ADH) is diabetes insipidus as a result of severe water loss from the body. Other samples that contribute acute abnormalities are the syndrome of inappropriate secretion of ADH (SIADH) and cerebral salt wasting syndrome which are more common and can resolve with proper treatment and laboratory evaluation, such syndromes have a chemical imbalance of salt and water in the body finding the correct treatment medical is crucial for improvement and prevent dehydration, cardiac complication, renal failure and even death.

In order to prevent TBI assessment must be done right away in order to diagnose correctly and treat the symptoms with laboratory evaluations and screenings of ACTH and TSH deficiencies during the acute period followed by 6- and 12-months evaluations. Also, it is recommended that evaluations every 3, 6, and 12 months take place for hormonal deficiencies is the signs and symptoms warrant it. In conclusion the pituitary gland regulates and secrets essentials hormones for our bodies to exist, grow and develop. The pituitary gland the hypothalamus favors each other and are both vulnerable to brain trauma. The hypothalamus releases hormones also known as releasing hormones that act on the pituitary gland which acts on other organs of the body releasing growth hormones (GH). In order to avoid brain injuries, patient education such as wearing proper safety gear as well as learning how to avoid such injuries and how to treat them plays an import role in nursing education.

Reference

Sayed, S. A. E. (2023, May 1). Physiology, pituitary gland. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK459247/

Tkacs, N. C., & Herrmann, L. L. (2025). Advanced Physiology and Pathophysiology: Essentials for Clinical Practice. Springer Publishing Company, LLC.

Sandel, E. (2022b, May 27). How does brain trauma affect brain hormones? Elizabeth Sandel, M.D. https://elizabethsandelmd.com/insights/how-does-brain-trauma-affect-brain-hormones/

Discussion P W3 Reply 2

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The pituitary is divided into 2 lobes with totally different functionalities, on the one hand we have the adenohypophysis as the anterior lobe and the neurohypophysis as the posterior lobe, both have very different mechanisms and regulations. Firstly, the adenohypophysis is responsible for producing and secreting six hormones which are adrenocorticotropic hormone (ACTH), thyrotropin (TSH), growth hormone or somatotropin (GH), prolactin, follicle stimulating hormone (FSH) and luteinizing hormone (LH), all are essential in endocrine regulation and have trophic effects on peripheral glands except prolactin and this regulation responds to or is influenced by circadian rhythms, whereas the neurohypophysis does not produce any hormones because it lacks glandular tissue but is responsible for storing and releasing oxytocin and vasopressin (ADH), both of which are synthesized in the hypothalamus (El Sayed et al., 3).

In the context of regulatory mechanisms, the adenohypophysis depends on releasing and inhibitory factors that are transmitted from the hypothalamus through the pituitary portal system, which makes it more susceptible to vascular injury. In contrast, the neurohypophysis reacts to direct neural signals originating from the hypothalamus through the hypothalamic-pituitary tract, which reduces its vulnerability to vascular perturbations (Sadiq & Tadi, 2023).

The mechanisms of secretion are also markedly different. In the adenohypophysis, hormone secretion is an active process that is regulated by specific hormonal stimuli from the hypothalamus; in contrast, the neurohypophysis passively discharges stored hormones in response to physiological stimuli, such as fluctuations in plasma osmolarity (in the case of ADH) or stimuli related to childbirth or lactation (in the case of oxytocin). These structural and functional disparities have significant implications for the clinical repercussions associated with their dysfunction. Disorders of the adenohypophysis often have a severe systemic impact due to its pivotal role within the hypothalamic-pituitary axis, which can lead to adrenal insufficiency, secondary hypothyroidism or infertility. In contrast, neurohypophyseal disorders often present as more specific and localized conditions, for example, diabetes insipidus caused by ADH deficiency or complications related to childbirth and lactation due to oxytocin deficiency (Santos Fontanez & De Jesus, 2024). When evaluating vulnerability to cranial trauma or inflammatory processes we have to point out that the adenohypophysis is more vulnerable to these factors because of its dependence on the sensitive pituitary portal system to receive hormonal signals from the hypothalamus, very different from the neurohypophysis which establishes a more direct connection with the hypothalamic axis through nerve fibers and less vascular requirement, so that in general it can be said that both lobes described are functionally integrated to the hypothalamus-pituitary axis. Both are fundamental to maintain endocrine homeostasis but at the same time the different regulations they have, hormonal secretions and their structural vulnerabilities lead to different and distinctive clinical patterns in the face of certain lesions or prolonged dysfunctions . 

References

El Sayed, S. A., Fahmy, M. W., & Schwartz, J. (3). Physiology, Pituitary Gland. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK459247/

Sadiq, N. M., & Tadi, P. (2023). Physiology, Pituitary Hormones. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK557556/

Santos Fontanez, S. E., & De Jesus, O. (2024). Neurohypophysis. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK560733/

Nursing Pharm Assignment 2

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Review a minimum of five academic articles and map out your research on the drug ibuprofen, creating a table that includes the information you found on your drug of choice including the author, the date, article name, location of the published source, and page number.

Discussion NT W3 Reply 1

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Self-efficacy theory (SET) was presented in 1977 as an ambitious attempt to provide a unifying theory of behavior change (Gallagher, 2012). SET is subset theory based on Bandura’s 1986 social cognitive theory. The theory of self-efficacy is defined as the concepts that allows an individual to complete a task and goals based on beliefs and the ability to successful complete certain task. It is important to understand that the self- efficacy theory is not weather an individual can complete a task or not but rather if that individual believes he can complete it. It is through thoughts and perception the humans can fulfill such tasks in order to fulfill and reach specific goals. In other words, SET is one’s belief to succeed in a certain situation. In fact, one of the basic notions of this concept is that you are more likely to participate in activities and delve into tasks for which you possess high self-efficacy and less likely to take action for those you possess low self-efficacy (Lunenburg, 2011).

           Our lives are a perfect example of self-efficacy, this includes careers, parenting, education, fitness and health. Many of us have goals and dreams, for example take into consideration this class, I as a student have a goal to finish my masters setting the self-efficacy theory in motion. Self-efficacy was defined as the individual’s perception of one’s ability to perform particular behaviors through four processes including cognitive, motivational, affective and selection processes. The stronger their cognitive perception of self-efficacy, the higher they set their goals and commitment to achieve these goals (Shorey, 2021). SET can be improved by proper environment and patient exposure to proper learning. One highlight of SET is a patient that is sick has lost control of the situation by not being able to take care of himself or the problem, this demonstrates a cognitive, motivational and section process contributing to self-efficacy theory. In my scope of practice as a nephrology nurse SET is demonstrated by every patient, I treat that is unable to take care of themselves who rely on a machine to clean their blood in order to live, their cognitive level is low due to the toxins in their body. Their dependency and loss of freedom to the dialysis machine can be overwhelming. Nurses must also apply the Theory of Symptom Self-Management to optimize patient outcomes by increasing perceived self-efficacy. In trauma situations, comfort for the patient includes touch, talk, posturing, and availability (Shorey, 2021).

Reference

Gallagher, M. W. (2012). Self-efficacy theory. Self-Efficacy Theory – an overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/psychology/self-efficacy-theory

Yilmaz, E. (n.d.). Self-efficacy: Theory, examples, and tips. The Berkeley Well-Being Institute. https://www.berkeleywellbeing.com/self-efficacy.html

Tkacs, N. C., & Herrmann, L. L. (2025). Advanced Physiology and Pathophysiology: Essentials for Clinical Practice. Springer Publishing Company, LLC.

Lunenburg, F. C. (2011). Self-efficacy in the workplace: Implications for motivation and performance. International journal of management, business, and administration, 14(1), 1-6.

Shorey, S. (2021, March 12). Self-efficacy in a nursing context. Health Promotion in Health Care – Vital Theories and Research [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK585659/#ch12.Sec1