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

Phillip January 21, 2025 No Comments

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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Date

Concept Map: The 3Ps and Mental Health Care

Major Depressive Disorder (MDD) is a complex mental health condition, which is also the third major cause of the burden of disease worldwide (Bains & Abdijadid, 2023). Psychological, Physiological, and Pharmacological factors (3Ps) are the factors that influence it. This assessment will present a concept map that visually organizes these key components to enhance understanding and support evidence-based mental health care.

Case Scenario

A 61-year-old female, Ivy Jackson, has exhibited symptoms of persistent sadness, weight loss, sleep disturbances, and emotional distress after a major life event, which is consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for MDD. Her condition needs a comprehensive approach, which includes her risk factors, diagnostic procedures, medications, complications, and nursing interventions.

Mental Health Diagnosis

Ivy Jackson, a 61-year-old female, presents with symptoms consistent with MDD as defined by the DSM-5. MDD is a serious mood disorder characterized by persistent feelings of sadness, loss of interest in daily activities, cognitive impairments, sleep disturbances, and major functional impairment (Bains & Abdijadid, 2023). Ivy’s symptoms align with DSM-5 diagnostic criteria, as she reports a depressed mood nearly every day, frequent crying episodes, and a sense of hopelessness following the unexpected end of her 38-year marriage. She also exhibits anhedonia, as she no longer enjoys previously pleasurable activities like walking or spending time with family. Additionally, she has experienced a weight loss of 10 pounds due to decreased appetite, insomnia with frequent nighttime awakenings, fatigue, and difficulty concentrating. Though she denies suicidal ideation, her emotional distress and social isolation place her at risk, warranting close monitoring.

Several risk factors contribute to Ivy’s diagnosis. Her psychosocial stressors, mainly the dissolution of her marriage, have triggered a major depressive episode. Additionally, her family history of depression, with both her mother and brother affected by the condition, increases her genetic vulnerability. From a medical standpoint, she has a history of hypertension and past depressive symptoms, particularly following major life changes such as her youngest child leaving for college. She was previously prescribed venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), but discontinued it due to withdrawal effects, which may have contributed to her current relapse. Non-adherence to antidepressant therapy is a known risk factor for worsening depression and increased symptom recurrence (Naudín et al., 2022).

While a specific event triggered Ivy’s symptoms, like her divorce and her presentation, aligns more closely with MDD rather than situational depression. Situational depression is typically short-term and directly linked to a stressor. In contrast, MDD persists even after the triggering event and is influenced by biological factors, including neurotransmitter imbalances and dysregulation of the Hypothalamic-Pituitary-Adrenal (HPA) axis (Remes, 2021). Given the chronic nature of her symptoms, the severity of her distress, and her past history of depressive episodes, Ivy’s diagnosis of MDD is well-supported by evidence-based research. Management will require a combination of pharmacologic treatment like escitalopram, psychotherapy, and lifestyle interventions aimed at improving her emotional well-being, adherence to treatment, and quality of life.

Concept Map for Ivy Jackson

Risk Factors & Signs and Symptoms

Psychological influences include Ivy Jackson’s recent divorce, which has triggered emotional turmoil, persistent despair, and withdrawal from social interactions. A family history of depression heightens her susceptibility, predisposing her to recurrent episodes. Physiologically, her medical history of hypertension and past depressive episodes further compound her vulnerability. Lifestyle factors such as inactivity, unintended weight loss, and chronic sleep disturbances exacerbate her symptoms. Pharmacologically, discontinuation of venlafaxine due to withdrawal effects places her at greater risk for relapse, emphasizing the necessity of medication adherence and careful transition planning.

Psychologically, Ivy experiences deep sadness, frequent crying, low motivation, and cognitive difficulties that disrupt daily life. Physiologically, fatigue, poor sleep, appetite loss, and weight reduction worsen her condition, while antidepressant side effects like nausea and headaches may affect treatment adherence.

Diagnostics and Complications

Psychologically, clinical evaluation using DSM-5 criteria is the primary method to confirm MDD. According to Chand and Arif. (2023), physiologically, laboratory investigations such as thyroid function tests, vitamin D screening, metabolic panels, Thyroid profiles, and Complete Blood Counts (CBC) are necessary to exclude underlying conditions that may mimic depressive symptoms. Pharmacologically, assessing past medication responses and adherence patterns informs treatment adjustments, ensuring optimal therapeutic outcomes.

Unaddressed psychological distress can lead to chronic depression, increased social detachment, and impaired decision-making. Physiological complications such as unregulated hypertension and nutritional deficiencies may emerge due to prolonged depressive episodes and poor self-care. Pharmacological challenges, including inconsistent medication use and withdrawal effects, further hinder recovery and elevate the risk of relapse. Close monitoring and timely intervention are essential to mitigate these risks.

Nursing Diagnoses and Interventions

Psychological nursing diagnoses include ineffective coping mechanisms due to emotional distress and impaired social interactions. Therapeutic communication, cognitive behavioral therapy, and interpersonal therapy are vital interventions to foster resilience and emotional stability. Physiological concerns such as disturbed sleep patterns and nutritional imbalances necessitate strategies like sleep hygiene education, dietary counseling, and encouragement of physical activity. CBT and Interpersonal Therapy (IPT) can also enhance coping mechanisms and social support (Lieshout et al., 2022). Pharmacological interventions focus on adherence reinforcement, side effect management, and patient education regarding the benefits of long-term medication compliance. A structured and interdisciplinary approach addressing psychological, physiological, and pharmacological dimensions is essential to optimizing Ivy’s mental and physical well-being. Holistic care, evidence-based interventions, and ongoing support will enhance treatment efficacy and improve her overall quality of life.

Conclusion

Ivy Jackson’s MDD is presented in a clear and evidence based manner in a well structured concept map, that show her risk factors, symptoms, diagnostics, pharmacological treatment, complications and nursing interventions. By addressing these elements through professional assessment and focused care strategies, it becomes possible to achieve a holistic approach to improving her mental health and general well being. This assessment combines clinical knowledge and patient centered care to help with treatment planning and better patient outcomes.

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