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 complex and debilitating psychiatric illness marked by enduring feelings of sadness, reduced pleasure in previously enjoyed activities, fatigue, appetite and sleep disturbances, and noticeable weight fluctuations. Frequently, MDD arises in response to profound life stressors, such as grief, trauma, or significant relational changes. It impacts not only emotional and psychological health but also physical and social functioning, often reducing overall quality of life (Bains & Abdijadid, 2023).

In the context of mental health nursing, recognizing the 3Ps—predisposing, precipitating, and perpetuating factors—is critical for holistic assessment and care planning. These factors help identify not only the root causes of the disorder but also the dynamics maintaining the depressive episode. In Ivy Jackson’s case, her symptom profile and psychosocial history clearly align with the diagnostic criteria of MDD. The nursing interventions aimed at her recovery must account for emotional healing and the social, biological, and psychological variables influencing her mental health.

Case Study Overview

Patient Background and Clinical Profile

Ivy Jackson is a 63-year-old woman facing emotional distress following the end of a nearly four-decade-long marriage, disrupted by her husband’s infidelity. Since this separation, Ivy has shown marked signs of psychological strain. Her reported symptoms include chronic fatigue, disrupted sleep, reduced appetite, emotional volatility, and a general inability to manage her usual daily responsibilities. These changes reflect a decline in both her emotional well-being and functional capacity, suggesting a major depressive episode.

Psychiatric Assessment and Diagnosis

Ivy’s symptomatology is consistent with the DSM-5-TR criteria for Major Depressive Disorder. She displays more than five hallmark symptoms—depressed mood, diminished interest in activities, energy loss, disturbed sleep, and social withdrawal—persisting beyond a two-week period and substantially impairing her social and occupational functioning. Although she denies suicidal ideation, her detachment and hopelessness highlight the need for immediate clinical intervention to mitigate risks of deterioration.

Etiological Factors and Risk of Relapse

Several variables contribute to Ivy’s depressive condition. The emotional trauma of her marital dissolution acts as a significant trigger. Furthermore, her family history of mood disorders introduces a biological vulnerability to depression. The empty nest transition and recent discontinuation of venlafaxine (an antidepressant) exacerbate her psychological instability. Research suggests that abrupt cessation of antidepressants can provoke relapse, particularly in cases where underlying neurochemical imbalances remain unresolved (Bains & Abdijadid, 2023).

Case Summary and Intervention Plan

An integrative treatment plan for Ivy must combine pharmacologic solutions with psychosocial and behavioral strategies. Selective serotonin reuptake inhibitors (SSRIs), such as escitalopram, are generally favored for their effectiveness and reduced side-effect profiles. Concurrently, engaging Ivy in Cognitive Behavioral Therapy (CBT) can be instrumental in addressing distorted thinking patterns and enhancing emotional regulation. Structured daily routines, physical activity, and supportive social connections serve as protective measures against recurrence and promote long-term wellness. The following table outlines key elements of Ivy’s case:

Table 1: Clinical Summary and Care Plan

Category	Details
Patient Information	Ivy Jackson, 63 years old; recently divorced after a 38-year marriage.
Presenting Symptoms	Fatigue, insomnia, appetite loss, sadness, emotional lability, anhedonia.
Diagnosis	Major Depressive Disorder (MDD) per DSM-5-TR criteria.
Psychosocial Factors	Divorce, genetic predisposition, medication withdrawal, empty nest phase.
Treatment History	Discontinued venlafaxine due to side effects.
Recommended Care	SSRIs (e.g., escitalopram), CBT, routine structuring, exercise, social support.
Prognosis and Risks	Favorable with adherence; relapse risk if untreated or noncompliant.

References

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