Capella 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

Understanding Major Depressive Disorder (MDD)

Major Depressive Disorder (MDD) is a prevalent and serious psychiatric condition marked by persistent low mood, loss of interest in daily activities, chronic fatigue, disturbances in sleep, and notable changes in appetite and body weight. It frequently develops following significant life stressors such as bereavement, traumatic events, or emotional separations. These stressors significantly impair an individual’s cognitive, physical, and social functioning (Bains & Abdijadid, 2023).

In the case of Ivy Jackson, her clinical profile aligns with MDD, as revealed through her mental health evaluation. Key factors in her assessment include psychosocial history, current symptom presentation, and underlying risk factors. The nursing care plan is constructed to support her emotional balance and promote gradual psychological recovery.

Case Study Overview

Patient Background and Symptomatology

Ivy Jackson, a 63-year-old woman, recently underwent a separation following her husband’s extramarital affair that ended their 38-year marriage. Since then, she has experienced significant psychological distress, manifesting in chronic fatigue, insomnia, diminished appetite, weight loss, persistent sadness, and emotional instability. Her symptoms impair her ability to function in daily life and demonstrate hallmark signs of MDD. Furthermore, her family history of depression adds to her vulnerability.

Psychiatric Evaluation and Diagnosis

DSM-5-TR Criteria and Clinical Indicators

Upon psychiatric evaluation, Ivy fulfills the diagnostic criteria outlined in the DSM-5-TR for Major Depressive Disorder. She experiences at least five major symptoms, including prolonged low mood, anhedonia (loss of interest), and fatigue, which persist beyond two weeks and significantly disrupt her routine. Emotional symptoms like detachment, helplessness, and irritability, alongside physiological disturbances such as insomnia and appetite loss, highlight her depressive state. Though she has no suicidal ideation, her social withdrawal raises concerns about potential deterioration if not adequately treated.

Contributing Factors and Relapse Considerations

Several factors contribute to Ivy’s depressive episode. Her unexpected divorce introduced intense emotional stress. Additionally, her genetic predisposition due to maternal family history of depression heightens her risk. Life transitions like the empty nest phase and discontinued use of venlafaxine due to side effects have further compounded her vulnerability. Discontinuation of antidepressant treatment is a known precipitant of symptom relapse in MDD.

Treatment Recommendations and Recovery Strategy

Unlike short-term adjustment disorders or bereavement-related sadness, MDD entails persistent neurochemical changes, such as disturbances in the hypothalamic-pituitary-adrenal (HPA) axis and serotonin dysregulation (Bains & Abdijadid, 2023). Consequently, Ivy’s recovery plan should integrate pharmacologic intervention—preferably with SSRIs like escitalopram—and nonpharmacologic therapies including Cognitive Behavioral Therapy (CBT). Complementary lifestyle modifications such as structured routines, physical activity, and strengthened social networks are crucial for long-term management and relapse prevention.

Table: Case Summary and Intervention Plan

Category	Details
Patient Information	Ivy Jackson, 63 years old, recently divorced after a 38-year marriage.
Presenting Symptoms	Fatigue, insomnia, weight loss, low mood, anxiety, emotional withdrawal, and lack of interest in previously enjoyed activities.
Diagnosis	Major Depressive Disorder (MDD) based on DSM-5-TR criteria (five or more symptoms for over two weeks with functional impairment).
Psychosocial Contributors	Divorce, emotional trauma, genetic predisposition, medication discontinuation, empty nest syndrome.
Treatment History	Previously treated with venlafaxine, discontinued due to adverse effects.
Recommended Interventions	Pharmacologic: SSRI (e.g., escitalopram); Nonpharmacologic: CBT, routine scheduling, physical activity, and social engagement.
Prognosis and Risks	Favorable with adherence to treatment; risk of symptom relapse if left untreated due to chronic nature and neurobiological involvement.

Reference List

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