Capella FPX 4015 Assessment 3
Capella FPX 4015 Assessment 3
Name
Capella university
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Concept Map: The 3Ps and Mental Health Management
Overview of Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD) is a significant mental health condition that interferes with an individual’s ability to function in daily life. It frequently coexists with physical illnesses, such as cardiovascular conditions, thereby complicating treatment outcomes and increasing the risk of mortality (Cui et al., 2024). Effective management of MDD necessitates a holistic strategy encompassing psychological, physiological, and pharmacological interventions—collectively described as the “3Ps.” This concept map is employed to apply the 3Ps framework to a real-life case study to promote a comprehensive, individualized care plan.
Case Study: Ivy Jackson
The featured case involves Ivy Jackson, a 63-year-old woman presenting with classic symptoms of MDD. After a divorce three weeks ago, Ivy began experiencing fatigue, insomnia, emotional distress, and unintended weight loss. While she does not report suicidal thoughts, her daily functioning is compromised due to anxiety and poor dietary habits. Ivy’s history of hypertension and familial predisposition to both depression and high blood pressure contribute to her mental and physical health challenges. A preliminary diagnosis of MDD has been made based on her symptoms and background, highlighting the multidimensional nature of her condition.
Clinical Overview
Mental Health Diagnosis
Ivy has been diagnosed with Major Depressive Disorder (MDD), a complex psychiatric condition that necessitates a detailed biopsychosocial assessment to understand contributing factors and inform treatment.
Pathophysiological Mechanisms
MDD is associated with neurochemical imbalances in serotonin, norepinephrine, and dopamine levels, which regulate emotions and cognition. Disruptions in these neurotransmitters—often triggered by stressful life events like trauma or loss—can lead to structural brain changes, particularly in the prefrontal cortex, impacting mood and decision-making (Cui et al., 2024).
Identified Risk Factors
Ivy’s condition is influenced by her genetic vulnerability, demonstrated through a family history of depressive and hypertensive disorders. Her postmenopausal state and limited social network further amplify her risk and symptomatology (Bond et al., 2022).
Pharmacologic Treatment
She is currently taking escitalopram to regulate serotonin levels, a key strategy in alleviating depressive symptoms. Additionally, mirtazapine is prescribed to aid in sleep and reduce anxiety, creating a synergistic effect for more comprehensive symptom control (Murphy et al., 2021).
Diagnostic Assessments
A multidimensional diagnostic process was followed, including a comprehensive interview, PHQ-9 depression screening, and a psychiatric physical evaluation to differentiate MDD from other medical conditions (Cui et al., 2024).
Physical and Emotional Assessment
Ivy displays various depressive symptoms such as frequent crying, social withdrawal, insomnia, and poor nutritional intake. The absence of social support exacerbates her emotional distress, promoting further isolation and diminishing her overall functioning (Bond et al., 2022).
Nursing Focus
Nursing Diagnosis
Ivy’s emotional distress following her divorce has led to maladaptive responses, including fatigue and sleep disturbances. Her physical symptoms, including poor nutrition and weight loss, contribute to her nonadherence to medications, exacerbating her depressive state and decreasing her quality of life.
Recommended Nursing Interventions
To support Ivy’s recovery, cognitive behavioral therapy (CBT) is advised to help restructure negative thoughts. Regular monitoring of medication compliance, patient education, and referrals to social work for community support are also essential. These strategies aim to foster empowerment and functional reintegration.
Potential Complications
Untreated MDD can evolve into a chronic condition, heightening the risk of suicidal ideation, cognitive deficits, and deepened social withdrawal. Early intervention is key to preventing further health decline and preserving Ivy’s quality of life (Cui et al., 2024).
Conclusion
MDD profoundly affects both psychological and physical well-being. By incorporating the 3Ps model—psychological, physical, and pharmacological elements—into treatment planning, a more personalized and effective care strategy is achieved. Ivy’s case exemplifies the need for this integrative model to ensure comprehensive recovery and enhance life quality.
Concept Map – The 3Ps and MDD Management
| Heading | Content Summary |
|---|---|
| Mental Health Diagnosis | Major Depressive Disorder (MDD), confirmed by clinical evaluation, PHQ-9 screening, and patient history. |
| Pathophysiology | Involves neurotransmitter imbalances (serotonin, norepinephrine, dopamine) and structural brain changes, especially in the prefrontal cortex (Cui et al., 2024). |
| Risk Factors | Genetic predisposition (family history), postmenopausal status, recent emotional trauma, and lack of social support (Bond et al., 2022). |
| Pharmacology | Escitalopram (SSRI) to regulate mood; mirtazapine for sleep and anxiety. Combination improves symptom management (Murphy et al., 2021). |
| Diagnostic Procedures | PHQ-9 screening, psychiatric interview, and full physical examination to exclude other health issues (Cui et al., 2024). |
| Physical Assessment | Symptoms include fatigue, insomnia, crying, social withdrawal, and poor appetite. Lacks social engagement and support (Bond et al., 2022). |
| Nursing Diagnosis | Emotional breakdown due to life stressors causing ineffective coping, fatigue, and nutritional deficiencies impacting recovery. |
| Nursing Interventions | CBT for thought restructuring, medication compliance education, follow-ups, and social support referrals to improve coping and function. |
| Complications | Chronic depression, cognitive decline, suicidal ideation, and further physical and social deterioration if left unaddressed (Cui et al., 2024). |
| Conclusion | Utilizing the 3Ps model allows for a holistic and effective care plan, improving quality of life and treatment outcomes for patients like Ivy Jackson. |
References
Bond, A. E., Bandel, S. L., Rodriguez, T. R., Anestis, J. C., & Anestis, M. D. (2022). Mental health treatment seeking and history of suicidal thoughts among suicide decedents by mechanism, 2003-2018. JAMA Network Open, 5(3), e222101. https://doi.org/10.1001/jamanetworkopen.2022.2101
Bruijniks, S. J. E., Meeter, M., Lemmens, L. H. J. M., Peeters, F., Cuijpers, P., & Huibers, M. J. H. (2021). Temporal and specific pathways of change in Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) for depression. Behaviour Research and Therapy, 151, 104010. https://doi.org/10.1016/j.brat.2021.104010
Capella FPX 4015 Assessment 2
Cui, L., Li, S., Wang, S., Wu, X., Liu, Y., Yu, W., Wang, Y., Tang, Y., Xia, M., & Li, B. (2024). Major Depressive disorder: Hypothesis, mechanism, prevention and treatment. Signal Transduction and Targeted Therapy, 9(1). https://doi.org/10.1038/s41392-024-01738-y
Murphy, S., Capitao, L., Giles, S., Cowen, P., Stringaris, A., & Harmer, C. (2021). The knowns and unknowns of SSRI treatment in young people with depression and anxiety: Efficacy, predictors, and mechanisms of action. The Lancet Psychiatry, 8(9), 824–835. https://doi.org/10.1016/S2215-0366(21)00154-1