Capella 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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Concept Map: 3Ps and Mental Health Care 

MAJOR DEPRESSIVE DISORDER (MDD)

A mental illness marked by enduring sorrow, disinterest in activities, challenges, irregular sleep patterns, changes in eating or weight, trouble focusing, and feelings of inadequacy. The DSM-5 states that five or more symptoms that substantially affect daily functioning and quality of life and endure for at least two weeks are necessary for a diagnosis (Rose et al., 2020).

RISK FACTORS

Risk factors include genetics, stressful life events, chronic illness, hormonal changes, and a history of mental health issues (Alibaysa, 2022). In Ivy Jackson’s case, her recent marital separation, family history of depression, menopause-related hormonal changes, and social isolation increase her vulnerability. These factors contribute to her emotional distress and depressive symptoms.

PHARMACOLOGY (MEDICATIONS)

Ivy Jackson is prescribed escitalopram (10 mg), a selective serotonin reuptake inhibitor (SSRI) from the SSRI class. It works by blocking serotonin reuptake in the brain, increasing serotonin to improve mood and reduce anxiety. She also takes mirtazapine (15 mg) at night, which regulates the sleep-wake cycle and helps manage her sleep disturbances (Toons et al., 2021).

DIAGNOSTIC STUDIES

Likewise, Ivy’s comprehensive mental health evaluation can be a primary diagnostic skill for MDD. Also, physical assessments and laboratory tests rule out medical causes like thyroid problems or vitamin deficiencies. In Ivy’s case, these steps supported a primary diagnosis of MDD based on symptoms and emotional distress.

NURSING DIAGNOSIS

• Depressed mood related to life stressors as seen in persistent sadness, fatigue, and loss of motivation.
• Disturbed sleep pattern related to anxiety as evidenced by sleep quality and reduced time of rest.
• Imbalanced nutrition: less than body requirements, as evidenced by a 10-pound weight loss and decreased appetite.

PATHOPHYSIOLOGY

Physiological changes include dysregulation of neurotransmitters, particularly serotonin, norepinephrine, and dopamine, affecting mood and cognition.
In hypothalamic–pituitary–adrenal (HPA) axis, an increasing cortisol level contributes to depressive symptoms (APA & Velligan, 2020). In this case, emotional stress disrupted Ivy’s HPA balance.

PHYSICAL ASSESSMENT SIGNS

Signs and symptoms include persistent sadness, fatigue, loss of interest, weight/appetite changes, sleep issues, and physical slowing or agitation. Ivy presents with significant weight loss (10 lbs), fatigue, and disturbed sleep. She also reports feeling helpless and demotivated. Her presentation with no acute medical issues also aligns with MDD.

DISEASE COMPLICATIONS

These include chronic illness, cognitive impairments, poor physical health, and risk of suicide or self-harm. In Ivy’s case, isolation, fatigue, medication nonadherence, and poor nutrition complicate her MDD. These highlight the need for a comprehensive plan (Alibaysa, 2022).

NURSING INTERVENTIONS

• Encourage self-help techniques and coping skills to improve emotional well-being.
• Monitor sleep hygiene and encourage consistent time for bedtime and waking.
• Provide emotional support; encourage small, frequent meals to increase food intake. (Firth et al., 2020)

References

Alshaya, D. S. (2022). Genetic and epigenetic factors associated with depression: An updated overview. Saudi Journal of Biological Sciences, 29(8), 103311. https://doi.org/10.1016/j.sjbs.2022.103311

Firth, J., Gangwisch, J. E., Borsini, A., Wootton, R. E., & Mayer, E. A. (2020). Food and mood: How do diet and nutrition affect mental wellbeing? BMJ, 369(1). https://doi.org/10.1136/bmj.m2382

P, S., & Vellapandian, C. (2024). Hypothalamic-Pituitary-Adrenal (HPA) axis: Unveiling the potential mechanisms involved in stress-induced Alzheimer’s disease and depression. Cureus, 16(8). https://doi.org/10.7759/cureus.67595

Capella FPX 4015 Assessment 3

Rose, A. L., Hopko, D. R., Lejuez, C. W., & Magidson, J. F. (2020). Major depressive disorder. In P. Sturmey (Ed.), Functional analysis in clinical treatment (2nd ed., pp. 339–373). Elsevier Academic Press. https://doi.org/10.1016/B978-0-12-805469-7.00015-2

Tonon, A. C., Pilz, L. K., Markus, R. P., Hidalgo, M. P., & Elisabetsky, E. (2021). Melatonin and depression: A translational perspective from animal models to clinical studies. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.638981