NURS FPX 4015 Assessment 3

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Capella university

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

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Date

Concept Map: The 3Ps and Mental Health Care

Major Depressive Disorder (MDD) is a serious mental health condition that ranks as the third leading cause of global disease burden (Bains & Abdijadid, 2023). Psychological, physiological, and pharmacological factors—referred to as the 3Ps—are crucial influences on MDD. This concept map organizes these factors visually to enhance understanding and support evidence-based mental health care practices.

Case Scenario:

Ivy Jackson, a 61-year-old woman, exhibits symptoms consistent with Major Depressive Disorder (MDD) following a significant life event. Symptoms such as persistent sadness, weight loss, sleep disturbances, and emotional distress meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) for MDD. These indicators require a comprehensive approach to care, including an evaluation of her risk factors, diagnostic processes, medications, complications, and nursing interventions.

Mental Health Diagnosis:

Ivy Jackson, at 61, presents with signs consistent with MDD, as outlined in the DSM-5. MDD is characterized by enduring sadness, loss of interest in daily activities, cognitive dysfunction, sleep disturbances, and severe functional impairment (Bains & Abdijadid, 2023). Ivy reports persistent low mood, frequent crying episodes, and hopelessness after the unexpected end of her 38-year marriage. She also experiences anhedonia, losing interest in activities she once enjoyed, like walking or spending time with family. Additionally, she has lost 10 pounds due to reduced appetite, suffers from insomnia, experiences fatigue, and has trouble concentrating. Although she denies suicidal thoughts, her emotional distress and social isolation place her at heightened risk and require close monitoring.

Several risk factors contribute to Ivy’s condition. Her psychosocial stressors, particularly the breakdown of her marriage, have triggered her depressive episode. A family history of depression in both her mother and brother increases her genetic vulnerability. Furthermore, Ivy has a history of hypertension and previous depressive symptoms, notably following major life changes, such as her youngest child leaving for college. She had previously been prescribed venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), but discontinued it due to withdrawal symptoms, potentially leading to her current relapse. Non-adherence to antidepressant medication is a known risk factor for worsening depression and recurrence of symptoms (Naudín et al., 2022).

Though Ivy’s symptoms were triggered by a specific life event—her divorce—her condition is more indicative of MDD than situational depression. Situational depression is typically short-term and directly related to stressors, while MDD persists even after the stressor and involves biological factors, such as neurotransmitter imbalances and dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis (Remes, 2021). Given the chronicity of Ivy’s symptoms, her previous history of depression, and the severity of her distress, her diagnosis of MDD is well-supported. Treatment will require a combination of pharmacological interventions, such as escitalopram, psychotherapy, and lifestyle modifications aimed at improving her emotional health, adherence to treatment, and overall quality of life.

Concept Map for Ivy Jackson:

Factors	Psychological	Physiological	Pharmacological
Risk Factors	Divorce, family history of depression, social isolation	Hypertension, past depressive episodes	Discontinuation of venlafaxine, non-adherence to medications
Signs & Symptoms	Persistent sadness, crying, hopelessness, anhedonia	Fatigue, weight loss, sleep disturbances, poor appetite	Side effects of antidepressants, withdrawal symptoms
Diagnostics	DSM-5 Criteria for MDD	Thyroid function tests, CBC, Vitamin D screening	Past medication responses, adherence patterns
Complications	Chronic depression, social detachment, impaired decision-making	Unregulated hypertension, nutritional deficiencies	Relapse, medication non-adherence
Nursing Interventions	Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT), social support	Sleep hygiene, dietary counseling, physical activity	Medication adherence support, side effect management

Conclusion:

Ivy Jackson’s case of Major Depressive Disorder (MDD) is clearly outlined in a structured concept map that identifies her risk factors, symptoms, diagnostic procedures, pharmacological treatments, complications, and nursing interventions. A thorough approach that combines clinical knowledge and patient-centered care will foster optimal treatment planning and enhance Ivy’s mental health and overall well-being.

References

Bains, N., & Abdijadid, S. (2023, April 10). Major depressive disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/

Chand, S., & Arif, H. (2023). Depression. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430847/

Lieshout, R. J. V., Layton, H., Savoy, C. D., Haber, E., Feller, A., Biscaro, A., Bieling, P. J., & Ferro, M. A. (2022). Public health nurse-delivered group cognitive behavioural therapy for postpartum depression: A randomized controlled trial. The Canadian Journal of Psychiatry, 67(6), 432–440. https://doi.org/10.1177/07067437221074426