Name
Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Major Depressive disorder (MDD) is a common and devastating psychological illness. MDD is associated with a variety of medical conditions, including cardiovascular illness and all disease-linked deaths. Further, MDD is among the top three determinants of suicidal thoughts. It considerably influences the standard of life, constituting 4.4% of years lived with disability (YLD) (Pasman et al., 2024). MDD care consists of three elements (3P): psychological, physiological, and pharmaceutical. This assessment is centered on the case study of a patient named Ivy Jackson, who is experiencing MDD symptoms. The A concept map will be designed which demonstrates 3P variables to improve interpretation and provide evidence-based treatments for MMD management.
Ivy Jackson, a 61-year-old woman, experienced tiredness, acute lack of sleep, significant decrease in weight, and persistent grief and distress after her divorce, which happened three weeks ago. This event left Ivy feeling scared, hopeless, and unmotivated. However, she has no suicidal ideation, but she has a poor appetite, which has led to a 10-pound weight loss in weeks, has trouble sleeping owing to worry, and psychological misery, all of which impair her everyday life. Her previous clinical history includes hypertension, and she comes from a family of depression sufferers, including her mother and brother. Her father, brother, and sister also had hypertension. Given all of the indications, she was predominantly diagnosed with MDD, impacting her health. The Sentinel-U case study is provided in Appendix.
The physical examination, which includes exhaustion, lack of hygiene and motivation in support of weight loss. It also involves a lack of motivation, sleep problems, intellectual focus issues, and emotional despair (Cui et al., 2024). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), MDD diagnosis requires at least five symptoms to persist for two weeks, including major signs of depression. The clinician should assess the likelihood of other conditions like schizophrenia or mania. Ivy’s case involves symptoms like sleep issues for three weeks, poor diet, weight loss of 10lbs, depression, and impaired social activities. Her diagnosis meets the DSM criteria for MDD.
MDD is diagnosed through a medical exam with the Patient Health Questionnaire 9 (PHQ-9), a nine-item self-assessment scale. Another useful strategy is applying the SDM-5 diagnostic criteria. (Patten, 2025). Other clinical tests include a thyroid-stimulating hormone test, comprehensive metabolic screening, a drug test, liver function test, and vitamin D tests to rule out physical reasons for mood issues and obtain baseline data (Chand et al., 2023). Ivy’s diagnostic and diagnostic compliance with DSM-5 and clinical tests are normal.
Escitalopram drug is an effective selective serotonin reuptake inhibitor (SSRI), which is prescribed for Ivy’s MDD. Escitalopram increases neuronal connections and serotonin, which control mental illness, fear, rage, suppression of stress, and appetite. It is usually tolerated and has few side effects. But if discontinued abruptly, it can lead to drowsiness, vomiting, and lethargy (Landy et al., 2023).
The MDD’s clinical signs are sad mood, insomnia, exhaustion, lack of hunger, anhedonia, reduced weight or weight loss, mood change, psychomotor issues, little motivation & lack of hope or interest, long absence from family and social life, and suicidal ideation (Chand et al., 2023). Physical diagnosis indicates diminished interaction with environment, lack of hygiene, psychological despair, and hunger. Recent signs in Ivy’s case include depression, insomnia, and weight loss (10lbs). Her signs meet the SDM criteria for MDD.
Nursing diagnosis for patients with MDD is via SDM-5 criteria, that is: Self-directed harm risk; Elevated likelihood of mental and social injury; violence due to stress, and social disputes Insufficient Coping Mechanisms: stress-management strategies, related to trauma Hopelessness: Overwhelming despair about future life events and responsibilities Tiredness: Debilitating lack of energy, Insomnia with depression Imbalanced Nutrition: Disorder consumption pattern, avoiding eating Chronic low Self-Esteem: Long-standing feelings of discouragement and lack of drive (Chand et al., 2023). They also assess patient physical condition and conduct clinical tests for diagnosis.
Nurses play an effective role in mental health problems. Using empathic communication, they encourage patients to engage in therapy. The priority is to normalize life, reduce symptoms of MDD and improve the client’s well-being using patient-centered care plans. They also educate patients about healthy practices and evaluate clinical care outcomes. They support medication management to improve drug efficacy and adjust doses, assess the side effects, and refer the patient to a psychiatrist. Nurses motivate clients to participate in social activities, effective communication and assess risk factors. Nurses also manage the client’s medication and diet. Nurses also promote self-care practices by enhancing patient’s awareness and self-management abilities by empowering them (Chand et al., 2023)
Chand, S. P., Arif, H., & Kutlenios, R. M. (2023). Depression (Nursing). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK568733/
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), 30. https://doi.org/10.1038/s41392-024-01738-y
Landy, K., Rosani, A., & Estevez, R. (2023). Escitalopram. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK557734/
Pasman, J. A., Bergstedt, J., Harder, A., Gong, T., Xiong, Y., Hägg, S., Fang, F., Treur, J. L., Choi, K. W., Sullivan, P. F., & Lu, Y. (2024). Causes and consequences of major depressive disorder: An encompassing mendelian randomization study. MedRxiv (Cold Spring Harbor Laboratory), 05(21), 24307678. https://doi.org/10.1101/2024.05.21.24307678.
Patten, S. B. (2025). A dimensional diagnostic strategy for depressive disorders. Journal of Clinical Medicine, 14(3), 844–844. https://doi.org/10.3390/jcm1403084
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