NURS FPX 4015 Assessment 3
NURS 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: 3Ps and Mental Health Care
Major Depressive Disorder (MDD) is a prevalent mental illness that has a high burden on individuals and families. It is distinguished by persistent sadness, loss of interest or pleasure, fatigue, disturbed sleep and/or eating patterns lasting for at least two weeks (American Psychiatric Association [APA], 2013). The DSM-5 states that five or more symptoms must occur for a diagnosis, including depressed mood or anhedonia.
Risk factors for MDD include family history, chronic illness, trauma, substance abuse and stressful life events. It may also stem from imbalances in neurotransmitters like serotonin, norepinephrine, and dopamine. Social isolation, poverty, and limited support may worsen the symptoms. Women are at a higher risk due to hormonal shifts, poor emotional and interpersonal issues, lack of physical activity, or stress-prone environments (Mayo Clinic, 2023).
NURS FPX 4015 Assessment 3
Pathophysiology involves dysregulation of neurotransmitters like serotonin, norepinephrine, and dopamine contributing to MDD. Structural brain abnormalities, such as decreased activity in the prefrontal cortex and hippocampus, also affect decision-making, memory, mood, and emotional regulation. Hormonal imbalances, like cortisol levels, increase stress. Sleep disturbances may amplify emotional symptoms. Genetic and epigenetic factors influence neurotransmitter synthesis and uptake (Nemeroff & Owens, 2020).
Etiology/genes, a selective serotonin reuptake inhibitor (SSRI) for MDD treatment, is prescribed by the primary healthcare provider. These drugs, such as fluoxetine, work by increasing serotonin levels in the brain (Gelenberg & Freeman, 2019). By blocking the reabsorption of serotonin in the brain, SSRIs increase the available amount of this neurotransmitter and improve mood. These are generally well-tolerated and have less side effects. SSRIs are recommended in guidelines for first-line treatment. Ineffective or withdrawn symptoms if stopped abruptly.
Signs and symptoms include persistent sadness, fatigue, insomnia, worthlessness, changes in appetite, lack of focus, and loss of interest in previously enjoyable activities. Patients may express feelings of guilt, hopelessness, or suicidal ideation. For children and adolescents, irritability may dominate rather than sadness. Physical symptoms like headaches, stomach aches, and chronic pain are common. Cultural and individual factors may influence how symptoms of depression manifest (Arbabi et al., 2017).
NURS FPX 4015 Assessment 3
Diagnostic studies for MDD include clinical interviews using DSM-5 criteria and the Patient Health Questionnaire-9 (PHQ-9). Tools such as the Beck Depression Inventory (BDI) help to assess symptom severity. Ruling out medical issues through blood work, thyroid function tests, and urine analysis is essential. These tests identify hormonal imbalances or other medical contributors. A physical exam usually confirms symptom severity. Sleep studies, EEGs and cognitive evaluations may help if symptoms are resistant or unclear (APA, 2013).
Untreated MDD can lead to complications such as increased suicidal ideation, substance abuse, poor work and social performance, and decreased quality of life. Chronic depression may result in relationship problems, physical health decline, and lower immune functioning. Cardiovascular disease, obesity, and diabetes are often associated with untreated depression. Postpartum depression can affect child-rearing. Suicide remains a leading cause of death in untreated MDD (Mayo Clinic et al., 2023).
NURSING DIAGNOSIS
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Imbalanced nutrition less than body requirements, r/t decreased appetite and energy level, as shown by weight loss. Related to MDD.
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Sleep pattern disturbance, as shown by fragmented sleep.
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Ineffective coping related to sleep pattern, as shown by weakness and loss of interest.
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Risk for violence directed to self/others, as shown by sadness, sobbing, and low interaction.
NURSING INTERVENTIONS
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Encourage rest, support, and nutrition-based care and monitor progress regularly.
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Pharmacological support (SSRIs) under physician supervision.
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Psychotherapy such as CBT to treat thought mechanisms and reduce distress (Ainsworth & Caplan, 2021).
References
Algorani, E. B., & Gupta, V. (2023). Coping mechanisms. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559031/
Bains, N., & Abdijadid, S. (2023). Major depressive disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559078/
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
Landy, K., & Estevez, R. (2023). Escitalopram. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557734/
Mrozek, W., Socha, J., Sidorowicz, K., Skrok, A., Syrytczyk, A., Chmiel, I. P., & Herbet, M. (2023). Pathogenesis and treatment of depression; role of diet in prevention and therapy review. Nutrition, 115, 112143–112143. https://doi.org/10.1016/j.nut.2023.112143
NURS FPX 4015 Assessment 3
Sun, Y., Fu, Z., Bo, Q., Mao, Z., Ma, X., & Wang, C. (2020). The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital. BMC Psychiatry, 20(1), 474. https://doi.org/10.1186/s12888-020-02885-6