NURS FPX 4015 Assessment 3

NURS FPX 4015 Assessment 3 Concept Map: The 3Ps and Mental Health Care

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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: The 3Ps and Mental Health Care

Major Depressive Disorder (MDD) is a significant mental health condition, ranking as the third leading cause of global disease burden (Bains & Abdijadid, 2023). The three major factors influencing MDD are psychological, physiological, and pharmacological components—commonly referred to as the 3Ps. Understanding these factors is essential for providing evidence-based mental health care. This concept map visually organizes these elements to support clinical decision-making and enhance patient care strategies.

Case Scenario

Ivy Jackson, a 61-year-old woman, presents with symptoms indicative of Major Depressive Disorder (MDD) following a significant life event. She reports persistent sadness, weight loss, sleep disturbances, and emotional distress, aligning with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for MDD. Ivy’s symptoms necessitate a holistic approach to care, incorporating risk factor evaluation, diagnostic assessment, pharmacological treatment, management of complications, and nursing interventions tailored to her condition.

Mental Health Diagnosis

Ivy’s clinical presentation is consistent with MDD, characterized by prolonged sadness, loss of interest in daily activities, cognitive impairment, sleep disturbances, and functional decline (Bains & Abdijadid, 2023). Her depressive symptoms emerged following the sudden dissolution of her 38-year marriage, leading to feelings of hopelessness, frequent crying episodes, and anhedonia. Additionally, she has experienced a 10-pound weight loss due to appetite reduction, insomnia, fatigue, and difficulty concentrating. While she denies suicidal ideation, her emotional distress and social isolation increase her risk, warranting close monitoring and intervention.

Multiple risk factors contribute to Ivy’s depressive episode. Her psychosocial stressors, including her divorce and family history of depression, elevate her vulnerability. Genetic predisposition is evident, as both her mother and brother have a history of depression. Furthermore, Ivy has hypertension and has experienced prior depressive episodes, particularly during major life transitions, such as her youngest child leaving for college. Previously, she was prescribed venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), but discontinued it due to withdrawal symptoms, which may have contributed to her current relapse. Non-adherence to antidepressants is a well-documented factor in the recurrence of depressive symptoms (Naudín et al., 2022).

Although Ivy’s symptoms were triggered by her divorce, her condition is more indicative of MDD rather than situational depression. Situational depression typically resolves once the stressor is removed, whereas MDD persists and involves biological dysregulation, including neurotransmitter imbalances and Hypothalamic-Pituitary-Adrenal (HPA) axis dysfunction (Remes, 2021). Given the chronic nature of her symptoms and her history of depression, a comprehensive treatment plan—including pharmacological therapy, psychotherapy, and lifestyle modifications—is essential to improve her emotional well-being, 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 highlights the multifaceted nature of Major Depressive Disorder (MDD). Through a structured concept map, her risk factors, symptoms, diagnostic methods, pharmacological treatments, complications, and nursing interventions are clearly outlined. A comprehensive approach integrating clinical expertise and patient-centered care is essential for optimizing her treatment plan, promoting adherence, and enhancing her overall mental health and quality of life.

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