Capella FPX 4015 Assessment 5

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

Comprehensive Head-To-Toe Assessment

Hello, my name is ____. Based on the case study of Sentinel U., a comprehensive body examination of the patient Aiyana Tehanata will commence. Her primary symptoms involve foot tingling, moderate pain at a level of 5, and higher-than-normal blood sugar levels. Throughout the evaluation of all major body systems, I will narrate my actions while reporting findings to Aiyana and delivering appropriate patient instructions, which will enhance her understanding of her illness.

Thorough and Professional Evaluation

I have started by evaluating your health status. The manner in which you rest and breathe heavily with exercise while maintaining a tripod position signals possible respiratory distress because heart oxygenation has decreased. You display signs of inadequate blood flow due to your pale skin and low body temperature. Your lower legs show minor enlargement. The manifestation of peripheral edema in the legs and hands forms a common condition for patients with Coronary Heart Disease (CHD) due to venous congestion.

Your vital signs are being checked as I proceed with the examination. Your body temperature currently measures 98.4 degrees Fahrenheit, which falls within the normal parameters. Your current heart rate of 96 beats per minute shows your heart is putting in extra effort to move blood throughout your body. The pressure readings in your blood measure 140/88 mmHg, indicating a condition that often occurs in CHD and hypertension, resulting in increased cardiovascular strain. Your breath rate reaches 22 per minute, which constitutes an elevated level that clinicians link to dyspnea caused by ischemic conditions leading to decreased blood flow to the heart tissue. You have an oxygen saturation level of 94% while breathing room air, although it falls below normal. The medical staff needs continuous monitoring to identify the risk of hypoxia as well as worsening ischemic conditions (Bhutta et al., 2024).

I will conduct your assessment of neurological functions. You must provide your identity, together with your geographical position and the date. The results indicate your cognitive abilities are intact because you show proper awareness of your identity along with your present setting and current date. With the aid of a penlight, I check your pupils, which are equal to each other and round in shape, while showing normal light sensitivity. You show no localized brain deficits, and you do not present signs that would indicate either a stroke or TIA, which CHD patients may develop. Your slowness of speech suggests that your heart works harder to function normally (Mayo Clinic, 2024). Your ability to coordinate movements was preserved according to results from the standard finger-to-nose test and tests of alternating movements.

Your HEENT examination finds a typical head shape without any detectable issues. Your eyes show a mild pallor in the sclera area, possibly because anemia exists as a common CHD comorbidity that impairs oxygen delivery. You do not display the yellowing characteristic of jaundice. The examination of your ears indicates a normal appearance without hearing problems. The examination of your nose shows no sign of congestion or nasal passages being flared open. A dry appearance of your mucous membranes indicates slight dehydration, which results from the diuretic medications used in CHD treatment (Mayo Clinic, 2024). Your oral examination shows no lesions, and your complete HEENT assessment indicates typical organ health apart from some minimal issues.

Heart assessment is the next step of this examination. I identify an S4 heartbeat while listening with the stethoscope because these sounds frequently appear in CHD patients due to left ventricular hypertrophy and reduced ventricular compliance. An irregular apical pulse indicates that atrial fibrillation might be present as a typical heart condition that develops from heart failure due to diminished blood flow in CHD patients. Weak blood flow through your extremities is shown through the diminished pulses detected at the radial and dorsalis pedis. The blockage of blood vessels known as atherosclerosis leads to peripheral arterial disease (PAD) in CHD patients, resulting in foot tingling (Mayo Clinic, 2024). The 45-degree jugular vein observation reveals no enlargement of veins, which prevents a diagnosis of right-sided heart failure. The dependent edema in your lower legs appears low-grade, and I believe it is mainly caused by structural vessel injuries instead of fluid accumulation.

The examination of your respiratory system begins with the use of my stethoscope at present. Your breath sounds remain clear as you demonstrate neither crackles nor wheezing noises. Your quick breathing pattern seems to result from reduced cardiac output that causes exercise-related breathing difficulties. Your condition of optimized air intake occurs in an upright position, which is known as orthopnea. I will conduct the assessment of your abdominal area. You show no swelling during physical examination. Hearing bowel sounds occurs throughout each of the abdominal regions since gastrointestinal function remains normal. The right upper quadrant shows mild pain upon touch, whereas no liver congestion signs are seen, making this different from right-sided CHF symptoms. The absence of both hepatomegaly and ascites points away from heart failure, since these abnormalities often occur in cases of heart failure (NIH, 2023).

The evaluation of your musculoskeletal system requires my attention at this time. Your hand grip reduces in strength, probably because of fatigue. You demonstrate weak leg muscle response when pushing against my hands with your feet through mild weakness, which indicates blood circulation issues, along with limited physical activity, while eliminating fluid retention as a factor. The reduced transport of oxygen alongside nutrients throughout your legs could result in the sensation in your feet becoming tingling. You do not present any deformities or contractures at the joints. The loss of muscle tissue in your lower limbs seems to stem from the combined effects of illness duration and limited physical movement.

I proceed with examining your skin. Your light-colored skin surface, along with slight coolness, suggests problems with circulation. The skin shows no markings such as rashes or lesions. The stretch on your lower legs manifests as shine because of prolonged fluid retention, yet lacks any dimples. The capillary refill test reveals white discoloration in your skin, which disappears and returns at a slow pace, indicating reduced blood circulation. The research results match symptoms that occur with arterial insufficiency, which is usually found in CHD patients (NIH, 2023).

Analysis of Diagnosis and Findings

Your insufficient blood flow to the heart stems from CHD, according to my evaluation of your condition. Your past history of blood pressure abnormalities, together with high cholesterol levels, raises your chances of getting this disease. Inadequate heart oxygen supply during my examination assessment led the heart to increase its workload, which generated elevated heart rate patterns along with unpredictable heartbeat patterns. The foot tingling sensation, together with dizziness, often indicates that poor circulation affects your condition, as seen with CHD patients.

The state of your heart becomes burdened by high blood pressure along with increased heart rate, yet the narrowing of your blood vessels results in reduced heart pumping effectiveness (NIH, 2023). CHD reduces heart function, which your doctor would manage through appropriate changes to your treatments and recommendations for better heart function, a recommended heart-healthy diet, and activity. Information about my evaluation with normal and abnormal results will help your physician create an optimal treatment plan. You can freely ask any questions you have.

Comprehension of Pharmacological Requirements

Treatment for CHD in Aiyana will require medication that supports heart pumping efficiency and prevents fluid accumulation in the body. The physician will select medication for your particular health needs, which include Furosemide (Lasix) and Methotrexate. The heart rate reduction and strain-decreasing properties of metoprolol help patients control their condition. Your exhaustion due to these medicines should decrease as weeks pass by. The medication Lisinopril manages blood pressure by relaxing blood vessels, enabling better heart pumping efficiency and reduced blood pressure levels. Tell our office right away if Lisinopril triggers a dry cough, since it is listed as a medication side effect. The aldosterone antagonist Spironolactone stabilizes fluid balance and reduces hypertension, and these benefits will help your condition. 

Keeping track of your blood sugar closely becomes your priority because beta-blockers might affect the management of your diabetes. Assessment and management of heart failure must omit NSAIDs, including ibuprofen, because they induce fluid retention that worsens your symptoms (American Heart Association, 2023). Inform the healthcare provider about any side effects you experience so immediate assessments can take place whenever you notice dizziness or swelling or discover unusual symptoms. I want to know if you need clarification either on the medications or on how they help treat your heart issues and diabetes.

Comprehension of Pathophysiological Mechanisms

Knowledge of CHD body processes remains essential for understandable healthcare. The heart functions as the blood distribution center of the body, while CHD develops from atherosclerosis that produces plaque deposits, which cause either blocking or narrowing of the coronary arteries. The blocked path interrupts the flow of oxygen and nutrients towards the heart muscle tissue. The harmful effects of CHD on the heart and blood vessels extend to liver circulation restriction that worsens oxygen delivery. The blocked oxygen supply to heart muscles causes angina (chest pain) along with shortness of breath, and will result in heart attacks when oxygen becomes critically scarce.

The circulatory deficiencies lead to dizziness and fatigue, as well as unpredictable irregularities in heartbeating patterns. While resting, normally, fluid accumulation in the lungs makes it harder to breathe until the situation is explained. Worsening CHD conditions will potentially result in the development of secondary heart problems, including heart failure and arrhythmias. Blood pressure checks, along with cholesterol tracking and symptom observation, must happen every day to properly control CHD (Schwinger, 2021). Inform your doctor right away about worsening chest pain, together with breathlessness, dizziness, or swelling, because this allows for fast heart health management.

Analytical Thinking and Clinical Decision-Making

The blockage of the heart arterial pathways diminishes heart oxygen delivery, which raises heart attack dangers and produces chest pain (angina) and foot numbness. The medication aspirin or clopidogrel stops blood clotting to prevent blockages, whereas atorvastatin, along with other statins, helps decrease cholesterol levels to prevent artery plaque formation. Medical staff use Nitroglycerin as an angina treatment because this medication expands blood vessels while relaxing their muscular walls. Blood flow improvement and symptom relief of foot tingling require medical treatments, and patients must follow healthy eating habits and exercise regularly for effective results (Kim & Schaller, 2023).

The use of beta-blockers including metoprolol assists in controlling hypertension and decelerating heart rate which reduces strain on the heart. Therapeutic use of ACE inhibitor lisinopril helps veins to relax thus enhancing blood circulation and decreasing heart stress. Listening to blood pressure alongside heart rate assessment is crucial for both checking treatment effectiveness and stopping complications from developing. Medical providers need to change medications when patients present differing responses to their prescribed treatments (American Heart Association, 2023).

CHD patients face an elevated risk for heart attacks, together with arrhythmias and strokes, which require proper complication prevention. To treat severe artery blockages, doctors usually perform angioplasty or implement bypass surgery to restore standard blood circulation in the body. Medical professionals provide blood-thinning drugs to decrease the possibility of blood clots forming in patients. Cholesterol testing, along with blood pressure monitoring, and laboratory assessments form important elements for early detection of heart-related problems. Patients must obtain lifestyle and self-care education because this knowledge helps them deal with CHD while eliminating other health difficulties.

Patients need to follow a diet that contains low amounts of saturated fats, cholesterol, and sodium to sustain healthy arteries. Regular physical exercise combined with smoking cessation reduces the likelihood of heart attacks, along with enhancing overall heart health. Patients need to know the early signs of chest pain, together with shortness of breath and dizziness, to immediately report to their healthcare provider (Diab et al., 2023).

CHD management according to the American Heart Association (AHA) and American College of Cardiology (ACC) requires medicine combinations together with lifestyle modification and routine patient monitoring. Medical research indicates that proper management of blood pressure and blood sugar and cholesterol levels helps decrease heart attack possibilities alongside enhancing lasting health. Healthcare providers achieve better patient success through the combination of updated CHD management guidelines and patient data integration to develop individualized care strategies that reduce complications (American Heart Association, 2023).

Conclusion

The management of CHD needs clinical examinations combined with medication and lifestyle changes, as well as ongoing medical check-ups. A combination of medication control, which includes beta-blockers, ACE inhibitors, and statins, with lifestyle adjustments involving healthy eating and exercise, helps patients regulate their symptoms to avoid further complications. Patient outcomes, together with long-term heart health improvement, require prompt detection as well as early medical intervention. Healthcare providers, alongside patients, must work together for better disease management that leads to enhanced quality of life.

References

American Heart Association. (2023, July 10). Medications used to treat heart failure. Www.heart.org. https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/medications-used-to-treat-heart-failure 

Bhutta, B. S., Alghoula, F., & Berim, I. (2024). Hypoxia. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK482316/ 

Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023). A heart-healthy diet for cardiovascular disease prevention: Where are we now? Vascular Health and Risk Management, 19(19), 237–253. https://doi.org/10.2147/VHRM.S379874 

Capella FPX 4015 Assessment 5

Kim, K. H., & Schaller, D. J. (2023). Nitroglycerin. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482382/ 

Mayo Clinic. (2024, August 13). Heart disease – diagnosis and treatment – mayo clinic. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/heart-disease/diagnosis-treatment/drc-20353124 

NIH. (2023, December 20). Coronary heart disease – diagnosis | NHLBI, NIH. Www.nhlbi.nih.gov. https://www.nhlbi.nih.gov/health/coronary-heart-disease/diagnosis 

Schwinger, R. H. G. (2021). Pathophysiology of heart failure. Cardiovascular Diagnosis and Therapy, 11(1), 263–276. https://doi.org/10.21037/cdt-20-302

Capella FPX 4015 Assessment 4

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

Caring for Special Populations Teaching Presentation

African Americans represent one of the largest racial minority groups in the United States and possess a unique cultural identity shaped by a complex, inequitable history. These historical and social factors have had a profound effect on their healthcare experiences and outcomes. Conditions such as hypertension, diabetes, cancer, and maternal mortality disproportionately affect African Americans compared to White Americans. Cultural beliefs also play a vital role in influencing health behaviors and care preferences. This presentation aims to explore the defining characteristics, cultural values, prevalent health disparities, and effective nursing approaches required to provide culturally appropriate care for African American patients.

Introduction to the Concerned Population

The African American population is characterized by a rich cultural heritage and a challenging history marked by systemic discrimination. Their healthcare needs are influenced by variables such as socioeconomic factors, healthcare accessibility, and deep-rooted cultural traditions. A significant feature of African American culture is the emphasis on family and communal support in health-related decision-making. Spirituality and religious faith are also integral, providing comfort and coping mechanisms in the face of health challenges (Omenka et al., 2020). However, despite these protective cultural elements, disparities persist. African American women, for instance, face disproportionately high maternal mortality rates, with women aged 30 to 34 experiencing rates more than four times higher than their White counterparts (Njoku et al., 2023).

Factors such as institutional racism, geographic disparities, and limited health insurance contribute to restricted healthcare access. Additionally, historical events, including unethical studies like the Tuskegee Syphilis experiment, have cultivated a deep-seated mistrust of the medical establishment (Shukla et al., 2025). Addressing these disparities requires culturally aware care, incorporating historical context, family-centered care models, and acknowledgment of spiritual beliefs to improve patient outcomes and engagement.

Cultural Values and Beliefs Related to Healthcare

Cultural values significantly shape healthcare behaviors and experiences within African American communities. Family plays a pivotal role, often participating actively in healthcare decisions rather than leaving them solely to the individual (Obringer, 2022). The importance of family cohesion extends to treatment preferences and interactions with healthcare professionals. Spirituality is another central component, influencing both health behaviors and responses to illness. In times of sickness, faith practices such as prayer and scripture reading are often employed alongside medical treatments, which are viewed as complementary to spiritual healing (Siler et al., 2021). Furthermore, some African Americans may incorporate traditional healing practices, such as herbal remedies or consultations with community elders and religious leaders. Understanding and respecting these traditions allows healthcare professionals to offer patient-centered, culturally sensitive care while ensuring adherence to necessary medical interventions.

Healthcare Inequities Faced by Racial Minorities

Persistent systemic inequalities, compounded by social determinants of health, result in disproportionate healthcare challenges for African Americans. Chronic conditions such as hypertension, diabetes, heart disease, and kidney disease occur at significantly higher rates compared to White Americans. These disparities are fueled by long-standing racial discrimination, healthcare access limitations, economic inequalities, and chronic stress exposure. Yearby et al. (2022) reported that in 2019, employer-provided health insurance covered 66% of White workers but only 47% of Black workers, with structural racism cited as a primary driver for the 1.5 times higher uninsured rate in African Americans. Black maternal mortality remains alarmingly high, four times that of White women (Njoku et al., 2023).

Beyond medical disparities, African Americans also contend with social factors like poverty, unsafe neighborhoods, food insecurity, limited transportation, and education disparities, all of which negatively impact health outcomes. Discrimination and implicit bias within healthcare systems foster mistrust and deter timely care-seeking behaviors (Shukla et al., 2025). The historical trauma associated with medical exploitation continues to breed skepticism toward medical authorities. Addressing these multifaceted disparities demands comprehensive, culturally sensitive interventions, advocacy for systemic reforms, and investment in community-based health programs aimed at achieving health equity.

Techniques for Culturally Competent Nursing Care

To deliver culturally competent care for African American patients, nurses must implement strategies that foster trust, respect cultural practices, and actively address disparities. Key interventions include:

• Establishing Trust and Transparent Communication: Recognizing the impact of historical injustices on African American communities is essential. Nurses should provide transparent explanations of care plans and validate patient concerns, which builds trust and improves care adherence (Shukla et al., 2025).

• Incorporating Spirituality in Care: Given the significance of spirituality in African American culture, healthcare providers should integrate spiritual care by collaborating with chaplains, offering prayer opportunities, and acknowledging religious needs within the care plan. This practice enhances coping abilities and healthcare engagement (Harvin et al., 2020).

• Facilitating Access to Community Resources: Nurses should address social determinants of health by connecting patients with community support services, including transportation programs, food banks, and local healthcare centers. These interventions help reduce healthcare barriers and improve outcomes (Tiase et al., 2022).

By integrating these culturally responsive strategies, nurses can offer more inclusive, equitable care and improve overall patient outcomes for African American populations.

Case Studies: Practicing Culturally Competent Nursing

Several case examples illustrate the importance of culturally sensitive nursing practices in caring for African American patients. One study evaluated the effectiveness of a faith-based hypertension management program among African American adults. The eight-week initiative combined health education with spiritual activities such as prayer and scripture reading for participants with a hypertension diagnosis (Harvin et al., 2020). Incorporating these culturally relevant elements improved patient trust, participation, and self-care outcomes.

Personal clinical experiences also highlight culturally competent care. In one case, a nurse in a primary care setting supported an African American patient with uncontrolled hypertension by involving church community members in the patient’s care plan. This culturally sensitive approach enhanced trust and medication compliance. In another instance, a nurse in an emergency department identified a patient’s reluctance during discharge education. Recognizing cultural mistrust, the nurse spent additional time clarifying the treatment plan, encouraged family involvement, and used open-ended communication techniques. This culturally aware method resulted in improved adherence to follow-up care.

Valuable Resources for Further Learning

Nurses aiming to expand their cultural competence can access several educational resources. The National Black Nurses Association (NBNA) offers professional development opportunities, workshops, and advocacy programs targeting African American healthcare (Dawson, 2021). The American Nurses Association (ANA) provides diversity and inclusion modules addressing health disparities and culturally appropriate care practices. Additionally, the Think Cultural Health initiative offers free, evidence-based Culturally and Linguistically Appropriate Services (CLAS) training tailored for nurses. These modules improve understanding of cultural beliefs, communication techniques, and equitable healthcare delivery (Think Cultural Health, n.d.). Local community initiatives, such as partnerships with African American churches and faith-based outreach programs, also provide valuable opportunities for culturally appropriate care experience. By utilizing these resources, nurses can enhance cultural competence and advocate effectively for health equity within African American communities.

Conclusion

In summary, delivering culturally competent care to African American patients requires an understanding of their cultural values, historical experiences, and the health disparities they face. Building trust, recognizing the importance of spirituality, addressing social determinants of health, and advocating for equity are essential nursing responsibilities. Evidence-based strategies and clinical experiences demonstrate that culturally responsive care fosters strong nurse-patient relationships and promotes health equity. Ongoing education, cultural self-awareness, and active engagement with community resources are vital for professional growth. Through dedication to culturally competent practices, nurses play a pivotal role in reducing health disparities and advancing healthcare equity for African American populations.

References

Dawson, M. A. (2021). Black nurses collaborative approach to addressing COVID-19 in Black communities. Journal of Racial and Ethnic Health Disparities, 8(3). https://doi.org/10.1007/s40615-021-00987-9

Harvin, L. A., Winter, D. M., Hoover, E. L., & Lewis, L. M. (2020). A faith-based intervention to improve hypertension management among African Americans. Journal of Christian Nursing, 37(1), 38–45. https://doi.org/10.1097/cnj.0000000000000676

Njoku, A., Evans, M., Nimo-Sefah, L., & Bailey, J. (2023). Listen to the whispers before they become screams: Addressing Black maternal morbidity and mortality in the United States. Healthcare, 11(3), 1–17. https://doi.org/10.3390/healthcare11030438

Obringer, K. (2022). African American family members’ needs and experiences during a loved one’s end-of-life. Illinois State University. Theses and Dissertations. https://doi.org/10.30707/etd2023.20230711063202575583.999952

Capella FPX 4015 Assessment 4

Omenka, O. I., Watson, D. P., & Hendrie, H. C. (2020). Understanding the healthcare experiences and needs of African immigrants in the United States: A scoping review. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-019-8127-9

Shukla, M., Schilt-Solberg, M., & Gibson-Scipio, W. (2025). Medical mistrust: A concept analysis. Nursing Reports, 15(3), 103–103. https://doi.org/10.3390/nursrep15030103

Siler, S., Arora, K., Doyon, K., & Fischer, S. M. (2021). Spirituality and the illness experience: Perspectives of African American older adults. The American Journal of Hospice & Palliative Care, 38(6), 618–625. https://doi.org/10.1177/1049909120988280

Think Cultural Health. (n.d.). Culturally and Linguistically Appropriate Services (CLAS) in nursing. Thinkculturalhealth.hhs.gov. https://thinkculturalhealth.hhs.gov/nursing/

Tiase, V., Crookston, C. D., Schoenbaum, A., & Valu, M. (2022). Nurses’ role in addressing social determinants of health. Nursing, 52(4), 32–37. https://doi.org/10.1097/01.nurse.0000823284.16666.96

Yearby, R., Clark, B., & Figueroa, J. F. (2022). Structural racism in historical and modern US health care policy. Health Affairs, 41(2), 187–194. https://doi.org/10.1377/hlthaff.2021.0146

Capella FPX 4015 Assessment 4

Capella 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: The 3Ps and Mental Health Management

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.

Case Study

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.

Mental Health Diagnosis Concept Map

Mental Health Diagnosis

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.

Diagnostic Procedure

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.

Pharmacotherapy

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).

Physical Assessment (Signs and Symptoms)

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

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.

Nursing Interventions

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)

References

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/

Capella FPX 4015 Assessment 3

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

Capella FPX 4015 Assessment 2

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

Enhancing Holistic Nursing Care With the 3Ps

Nursing practice integrates key scientific disciplines that support sound clinical judgment, informed decision-making, and compassionate, patient-focused care. Core areas such as holistic care, pathophysiology, pharmacology, and physical (3Ps) assessment are essential in promoting high healthcare quality and safety (Keefer et al., 2022). This discussion examines the importance of each domain separately, demonstrates how they are interrelated, and explains how their combined application can enhance clinical practice and lead to better patient outcomes.

Holistic Nursing Care: Definition and Usefulness for Patients and Nurses

Holistic nursing emphasizes the importance of treating the whole person by considering the continuous relationship between physical health, emotional stability, mental clarity, spiritual fulfillment, and environmental influences during recovery. The American Holistic Nurses Association (AHNA) highlights that all nursing care is deeply rooted in supporting both physical and spiritual healing (AHNA, 2025). This model of care emphasizes patient-centeredness by blending clinical expertise with empathy rather than solely relying on therapeutic communication or varied interventions to achieve health-related goals.

While symptom management remains a component of holistic nursing, the primary focus lies in enhancing individuals’ overall health and quality of life. Numerous studies highlight the positive impact of holistic care on patient outcomes. Research shows that patients receiving holistic interventions report greater satisfaction, improved emotional resilience, more effective symptom management, and quicker recovery times (Keefer et al., 2022). Incorporating mindfulness, therapeutic touch, and complementary therapies has been shown to improve physical and mental health by alleviating stress, reducing discomfort, and easing anxiety. For nurses, this approach improves patient care and contributes to professional well-being.

Nurses practicing holistically often experience greater job fulfillment and are less prone to burnout. They develop stronger therapeutic relationships and find deeper meaning in patient interactions, which fosters a sense of professional purpose (Hlubocky et al., 2021). Holistic nursing promotes self-care strategies that help nurses build resilience and sustain long-term professional engagement.

Pathophysiology in Nursing Practice

Pathophysiology describes how disease alters the body’s normal functional and structural characteristics. A scientific understanding of disease processes is a deep appreciation of how states of health develop and manifest in the various systems of the body. Nurses with an appreciation of disease processes can easily note patient states under normal care and identify early signs of disease. The capacity to anticipate disease progression enables them to offer high-quality, patient-tailored treatments that improve patient outcomes (Day & Hagler, 2024).

Understanding the etiology and the pathophysiological processes underlying disease provides a nurse with more authority to offer holistic, patient-tailored care. For example, an appreciation of chronic obstructive pulmonary disease (COPD) pathophysiology allows nurses to anticipate respiratory distress because they understand how airway inflammation and excess mucus production cause airflow limitation and compromised gas exchange. Likewise, appreciation of the pathophysiological underpinnings of liver cirrhosis allows nurses to anticipate complications such as ascites or hepatic encephalopathy because they value the impact of impaired liver function on fluid balance and the accumulation of toxins (Petrò et al., 2022).

Pathophysiology allows nurses to think beyond the limits of individual body systems because it illustrates how disease affects the overall health of the body. For example, systemic lupus erythematosus (SLE), a disease of autoimmune origin, can cause damage to multiple body parts such as the kidneys, skin, joints, and brain. It can cause widespread inflammation, tiredness, and susceptibility to infection. Appreciation of these widespread, multi-organ effects allows nurses to offer holistic care that addresses multiple interconnected features of the patient’s health (Ota et al., 2022). With pathophysiological knowledge, nurses can make informed, evidence-based clinical decisions, function as effective patient advocates, and offer useful expertise to interprofessional health teams. 

Pharmacology in Nursing Practice

 Pharmacology is vital in nursing as it focuses on how medications interact with the human body. A strong foundation in pharmacology equips nurses with the ability to select appropriate medications, administer them accurately, and systematically monitor their effects on patients. With this knowledge, nurses can anticipate potential side effects and identify drug interactions, allowing them to develop individualized medication plans tailored to each patient’s needs (Day & Hagler, 2024). In clinical settings, nursing care depends heavily on pharmacological expertise to choose the most suitable medications based on the patient’s health status and existing conditions. Reaching therapeutic drug levels requires nurses to understand correct dosages, delivery methods, and timing of administration.

For instance, administering anticoagulants like warfarin necessitates comprehension of dosage adjustments based on INR levels to prevent clot formation while avoiding excessive bleeding (Dager et al., 2023). Evaluating the effectiveness of medications involves more than just identifying immediate side effects. Nurses assess long-term therapeutic benefits and watch for delayed adverse reactions, ensuring a holistic view of how medications effect the patient’s overall well-being. For example, individuals on antipsychotic medications should be monitored for improvements in behavioral symptoms and metabolic changes, such as weight gain and blood sugar fluctuations (Lizcano et al., 2023). Pharmacology supports treating physical conditions, emotional well-being, and social factors influencing patient health. 

Physical Assessment in Nursing Practice

. The systematic process nurses use to acquire comprehensive patient health information includes physiological, psychological, and functional abilities. The process incorporates the process of health history-taking and inspection, palpation, percussion, and auscultation to acquire vital information, which informs clinical practice. Physical assessment assists nurses in constructing a fundamental understanding of patient information to formulate certain care plans and assess plan effectiveness in the long term (Day & Hagler, 2024). Physical examination assists nurses in getting objective and subjective patient information, which indicates current medical conditions and assessing potential danger factors. For example, a nurse detects early signs of pressure injury in immobile patients through physical skin integrity examination.

A nurse auscultates breath sounds to detect abnormal lung sounds, indicating respiratory failure by detecting crackles or wheezing (Kahar, 2025). By acquiring data, nurses formulate appropriate nursing diagnoses, which inform the determination of major interventions based on patient needs and urgency. Medical staff who detect a trend of high blood pressure readings between successive tests can detect hypertension before it becomes advanced by ordering appropriate examinations and interventions. The information acquired through physical assessments directly informs nursing care planning processes (Kahar, 2025). Nurses can establish realistic goals, choose effective evidence-based interventions through assessment data, and predict what outcomes patients will receive.

Integration and Application of 3Ps

Effective evidence-based nursing practice integrates pathophysiology, pharmacology, and physical assessment knowledge. These core domains complement each other, enabling nurses to make health related decisions, deliver timely interventions, and provide holistic care tailored to patient needs. This interdisciplinary approach is vital across various clinical scenarios, as shown in the examples below:

Example 1: Managing Acute Asthma Attack in a Pediatric Unit

When caring for a child experiencing an acute asthma attack, nurses apply their understanding of pathophysiology to recognize airway constriction and inflammation as the primary causes of breathing difficulty. This knowledge prompts a focus on evaluating respiratory effort, observing accessory muscle use, and measuring oxygen saturation levels (Thompson et al., 2022). Pharmacological expertise is essential when administering fast-acting bronchodilators such as levalbuterol. Nurses must understand how these medications function to relax bronchial muscles and monitor for side effects like jitteriness or increased heart rate. Physical assessment allows for real-time evaluation of treatment response by checking breath sounds, tracking changes in respiratory rate, and reassessing oxygen levels. Combining these domains ensures that care is responsive, precise, and centered on improving the child’s respiratory function.

Example 2: Managing Hypertension in the Community Health Setting

Nurses usually encounter patients with chronic hypertension in a community clinic. Pathophysiological understanding allows nurses to comprehend how the long-standing high blood pressure may lead to cardiovascular harm, renal stress, and increased stroke risk. Such an understanding reinforces the importance of maintaining blood pressure at a target level. Pharmacological understanding forms the basis of drug management, e.g., ACE inhibitors or calcium channel blockers. Nurses should also know the mechanisms by which these medications act, proper dosing protocols, and side effects such as electrolyte imbalance or persistent cough (Baker et al., 2023). Physical examination is also important through regular blood pressure monitoring, peripheral edema monitoring, and monitoring of signs of medication effect or reaction. By synergizing these areas of expertise, nurses can alter care plans, facilitate lifestyle changes, and collaborate with the extended healthcare team to prevent complications and contribute to long-term patient health.

Conclusion

Integrating holistic care with 3Ps assessment forms the foundation of safe, evidence-based nursing practice. By recognizing the interdependence of these areas, nurses are better equipped to make thoughtful clinical choices, provide care tailored to individual needs, and support the best possible health results. Together, they enhance modern nursing care’s quality, efficiency, and compassion.

References

AHNA. (2025). Holistic nursing practice. Ahna.org. https://www.ahna.org/American-Holistic-Nurses-Association/Resources/Holistic-Nursing-Practice

Dager, W. E., Trujillo, T. C., & Gilbert, B. W. (2023). Approaches to precision‐based anticoagulation management in the critically Ill. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 43(11), 1221–1236. https://doi.org/10.1002/phar.2868 

Day, K., & Hagler, D. A. (2024). Integrating the 4Ps in masters-level nursing education. Journal of Professional Nursing, 53, 16–24. https://doi.org/10.1016/j.profnurs.2024.04.003 

Hlubocky, F. J., Dokucu, M. E., & Back, A. L. (2021). The ethical implications of burnout: A moral imperative to prioritize physician well-being, resilience, and professional fulfillment. Springer EBooks, 87–111. https://doi.org/10.1007/978-3-030-84785-2_7 

Capella FPX 4015 Assessment 2

Kahar, L. A. (2025). Challenges in intensive care management of a patient with retropharyngeal abscess and mediastinal extension: A case report. Bioscientia Medicina Journal of Biomedicine and Translational Research, 9(4), 7177–7189. https://doi.org/10.37275/bsm.v9i4.1265 

Keefer, L., Bedell, A., Norton, C., & Hart, A. L. (2022). How should pain, fatigue, and emotional wellness be incorporated into treatment goals for optimal management of inflammatory bowel disease? Gastroenterology, 162(5), 1439–1451. https://doi.org/10.1053/j.gastro.2021.08.060 

Lizcano, L., Villamizar, V. V., Duarte, E. B., Pacheco, H., Paredes, C. S., Bermúdez, V., & Porras, D. (2023). Metabolic adverse effects of psychotropic drug therapy: A systematic review. European Journal of Investigation in Health, Psychology and Education, 13(8), 1505–1520. https://doi.org/10.3390/ejihpe13080110 

Ota, Y., Srinivasan, A., Capizzano, A. A., Bapuraj, J. R., Kim, J., Kurokawa, R., Baba, A., & Moritani, T. (2022). Central nervous system systemic lupus erythematosus: Pathophysiologic, clinical, and imaging features. RadioGraphics, 42(1), 212–232. https://doi.org/10.1148/rg.210045 

Capella FPX 4015 Assessment 2

Petrò, L., Colombo, S., Scaffidi, I., Molinari, P., Penzo, B., Cozzi, P., Guffanti, E., Cibelli, E., Guarnieri, M., Saglietti, F., & Gasperi, A. D. (2022). Acute liver failure: Definition, epidemiology and management – Update 2022. Springer EBooks, 19–47. https://doi.org/10.1007/978-3-031-14612-1_2 

Capella FPX 4015 Assessment 1

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

NURS FPX 4015 Assessment 5 Comprehensive Head-to-Toe Assessment

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

Comprehensive Head-to-Toe Assessment

Introduction and Initial Observations

Hello, Ms. Jackson. My name is __, and today I will perform a comprehensive head-to-toe assessment to evaluate your overall health status. This evaluation will help us identify any health concerns and develop an appropriate care plan. Please let me know if you feel any discomfort during the assessment, and we can take breaks as needed.

Upon observing you, I note your posture, facial expressions, and overall demeanor. You appear slightly tense, with mild signs of fatigue. To assess your mental status, I will ask you a few questions. Ms. Jackson, can you state your full name? Do you know today’s date and your current location? Thank you for your responses. Additionally, I would like to understand your emotional well-being. Have you been experiencing mood changes, trouble sleeping, or persistent feelings of sadness or anxiety? Your mental health is just as important as your physical health, and together, we will develop a supportive plan to address any concerns.

Neurological and Cardiovascular Assessment

To evaluate your neurological health, I will begin with a pupil reaction test. Your pupils react equally to light, which is a good sign. Next, I will check your eye movements—please follow my finger without moving your head. Your eye movements appear smooth. Now, I will assess your reflexes by tapping below your knee, and I observe a normal response. Let’s test your grip strength—please squeeze my fingers tightly. Your strength is equal on both sides. Lastly, to assess coordination, please touch your nose with your finger and then reach out to touch my hand. Your coordination is intact.

Now, let’s examine your cardiovascular health. I will listen to your heart sounds using a stethoscope. Please take a few deep breaths. Your heart sounds are clear, and your pulse is steady. Next, I will check your blood pressure, which is 145/90—slightly elevated. Several factors, including stress and diet, can contribute to this, which we will discuss further. Lastly, I will check your capillary refill by pressing on your fingertips. Your circulation appears normal.

Respiratory, Abdominal, and Musculoskeletal Assessment

For the respiratory assessment, I will listen to your lungs by placing my stethoscope on different areas of your chest and back. Please take a deep breath in and out. Your lung sounds are clear, with no abnormal wheezing or crackles. Next, I will examine your abdomen by gently pressing on different areas—please let me know if you experience any discomfort. Your abdomen is soft, with no tenderness or unusual masses, and your bowel sounds are normal.

Now, I will assess your musculoskeletal system and skin. I will check joint mobility by asking you to raise your arms and move them in a circular motion. That looks good. Next, let’s assess your leg strength—please push against my hands with your feet. Your strength is equal on both sides. Lastly, I will examine your skin for any abnormalities. Your skin appears healthy, with no signs of sores, rashes, or swelling. Your nails also show no discoloration or abnormalities.

Table: Comprehensive Head-to-Toe Assessment Findings

Discussion of Diagnosis and Findings

Ms. Jackson, based on my assessment, you are experiencing symptoms that may be linked to anxiety and depression. These symptoms can contribute to fatigue, poor concentration, sleep disturbances, and changes in appetite. According to the Centers for Disease Control and Prevention (CDC, 2023), mental health conditions such as depression and anxiety can lead to physical health issues, including restlessness, fatigue, and mood instability. Additionally, muscle tension was observed, which is commonly associated with stress and anxiety.

You also reported feeling low, lacking motivation, and experiencing overwhelming emotions, which align with symptoms of major depressive disorder (CDC, 2023). The excessive worry and restlessness you described may indicate an anxiety component. Mental health conditions are treatable, similar to chronic physical conditions like hypertension. Addressing these findings will allow us to create a personalized treatment plan to improve your quality of life. Do you have any questions about my findings? It is important that you feel informed and comfortable with the next steps.

References

Calvi, A., et al. (2021). Antidepressant drugs effects on blood pressure. Frontiers in Cardiovascular Medicine, 8(8). https://doi.org/10.3389/fcvm.2021.704281

CDC. (2023). Mental health conditions: Depression and anxiety. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html

Chu, A., & Wadhwa, R. (2023). Selective serotonin reuptake inhibitors. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554406/

Cleveland Clinic. (2022). Neurotransmitters. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22513-neurotransmitters

NURS FPX 4015 Assessment 5

Ghodeshwar, G. K., et al. (2023). Impact of lifestyle modifications on cardiovascular health. Cureus, 15(7). https://doi.org/10.7759/cureus.42616

Nakao, M., et al. (2021). Cognitive-behavioral therapy for mental health and stress. BioPsychoSocial Medicine, 15(1), 1–4. https://doi.org/10.1186/s13030-021-00219-w

NURS FPX 4015 Assessment 4

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

Caring for Special Populations: Teaching Presentation

Understanding Housing Insecurity and Its Health Impact

Housing insecurity, characterized by the lack of stable, adequate, and affordable housing, significantly impacts the well-being of affected individuals. Many people experiencing housing insecurity reside in temporary shelters, motels, or with family and friends due to financial constraints. Others may be forced to relocate frequently or live in unsafe conditions, leading to chronic stress and negative health outcomes (National Low Income Housing Coalition [NLIHC], 2023).

Certain groups, such as individuals with disabilities, low-income families, and marginalized communities, are disproportionately affected, exacerbating socioeconomic disparities. The NLIHC (2023) reports that approximately 11 million households, or one in four renters in the United States, struggle with housing affordability. Financial hardship further limits access to healthcare, forcing many individuals to delay medical care due to concerns about cost, lack of insurance, and transportation barriers. Poor living conditions and limited access to nutritious food contribute to chronic illnesses such as hypertension, diabetes, and respiratory diseases (Fitzpatrick & Willis, 2021). Mental health disorders, including depression and anxiety, are also prevalent, often worsened by financial instability. Many individuals struggle to adhere to medication regimens and rely on emergency care for preventable conditions. Expanding community-based healthcare programs and social support networks is essential to mitigating these challenges (Willison et al., 2021).

Cultural Considerations in Nursing Care

Culturally competent nursing care requires understanding the unique challenges and health disparities faced by individuals experiencing housing insecurity. Many prioritize basic survival over medical care, leading to untreated chronic conditions and delayed treatment. Mobile health clinics offering services directly in shelters and community centers can improve access to care while reducing transportation barriers (Rennert et al., 2024).

Trust in the healthcare system is another significant issue for this population, often due to past negative experiences and perceived discrimination. Hernandez et al. (2021) highlight the importance of trauma-informed care and nonjudgmental communication in fostering trust. Providing cultural competence training for healthcare providers can enhance patient engagement and adherence to treatment plans.

Additionally, financial instability and lack of identification documents can prevent individuals from accessing healthcare services. Nurses play a critical role in connecting patients with social workers and community organizations that offer low-cost or free healthcare. Collaborations with food pantries, housing agencies, and other social services can address social determinants of health and improve long-term well-being (Garcia et al., 2024). Implementing culturally responsive strategies enables healthcare providers to reduce disparities and enhance patient outcomes.

Healthcare Disparities and Social Determinants of Health

Individuals experiencing housing insecurity face substantial healthcare disparities due to financial instability, limited medical access, and social stigma. Many depend on emergency departments for treatable conditions, exacerbating chronic illnesses, increasing hospitalization rates, and raising mortality risks (Garcia et al., 2024). Limited access to vaccinations and routine screenings further increases susceptibility to infectious diseases.

Subpopulations within the housing-insecure community face unique challenges. Families with children struggle with pediatric care and educational disruptions, while elderly individuals often find it difficult to manage chronic illnesses without stable housing. Veterans are at higher risk for mental health disorders and substance abuse, and LGBTQ+ youth frequently experience homelessness due to family rejection, increasing their vulnerability to violence and exploitation (Miller, 2021).

Addressing these disparities requires a comprehensive approach. Mobile clinics can deliver essential healthcare services directly to shelters and public spaces, reducing barriers to care. Trauma-informed nursing practices help build trust and improve patient engagement. Social workers and housing programs are essential in connecting individuals with financial assistance and stable housing solutions. A notable example of culturally competent healthcare is the Boston Health Care for the Homeless Program (BHCHP), which integrates medical, mental health, and substance use treatment in shelters and community settings (Boston Health Care for the Homeless Program, 2024).

The social determinants of homelessness are far-reaching. Economic barriers such as unemployment, low wages, and rising housing costs contribute significantly to housing insecurity. Environmental factors, such as exposure to extreme weather and unsanitary conditions, increase health risks, including respiratory infections and dehydration (Anthonj et al., 2024). Expanding Medicaid eligibility and implementing housing-first initiatives are vital in addressing these systemic issues. Policies should focus on decriminalizing homelessness, expanding low-barrier healthcare access, and investing in permanent supportive housing to improve long-term stability and health outcomes.

Table: Strategies for Culturally Competent Nursing Care

References

Anthonj, C., Mingoti Poague, K. I. H., Fleming, L., & Stanglow, S. (2024). Invisible struggles: WASH insecurity and implications of extreme weather among urban homeless in high-income countries – A systematic scoping review. International Journal of Hygiene and Environmental Health, 255, 114285. https://doi.org/10.1016/j.ijheh.2023.114285

Boston Health Care for the Homeless Program. (2024). Street team. https://www.bhchp.org/services/street-team/

Deering, M. (2024, May 3). Cultural competence in nursing. NurseJournal. https://nursejournal.org/resources/cultural-competence-in-nursing/

Fitzpatrick, K. M., & Willis, D. E. (2021). Homeless and hungry: Food insecurity in the land of plenty. Food Security, 13(1). https://doi.org/10.1007/s12571-020-01115-x

Garcia, C., Doran, K., & Kushel, M. (2024). Homelessness and health: Factors, evidence, innovations that work, and policy recommendations. Health Affairs, 43(2), 164–171. https://doi.org/10.1377/hlthaff.2023.01049

Hernandez, N. C., Leal, L. M. R., & Brito, M. J. M. (2021). Building culturally competent compassion in nurses caring for vulnerable populations. Journal of Holistic Nursing, 40(4), 089801012110627. https://doi.org/10.1177/08980101211062708

NURS FPX 4015 Assessment 4

Miller, L. (2021). Statistics on veterans and substance abuse. Veteranaddiction.org. https://veteranaddiction.org/resources/veteran-statistics/

National Low Income Housing Coalition. (2023). A shortage of affordable homes. https://nlihc.org/sites/default/files/gap/Gap-Report_2023.pdf

Rennert, L., et al. (2024). Mobile health clinics for vaccinations to underserved communities. Public Health in Practice, 8, 100550. https://doi.org/10.1016/j.puhip.2024.100550

Willison, C. E., et al. (2021). Technically accessible, practically ineligible: Medicaid expansion and chronic homelessness. Journal of Health Politics, Policy and Law, 46(6). https://doi.org/10.1215/03616878-9349142

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: The 3Ps and Mental Health Care

Major Depressive Disorder (MDD) is a prevalent mental health condition, ranking as the third leading cause of global disease burden (Bains & Abdijadid, 2023). The three primary factors influencing MDD include psychological, physiological, and pharmacological components—collectively known as the 3Ps. Understanding these elements is essential for developing evidence-based mental health care strategies. This concept map serves as a structured approach to organizing these factors, aiding in clinical decision-making and improving patient-centered care.

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, which align with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for MDD. Her symptoms require a comprehensive approach, including an evaluation of risk factors, diagnostic assessments, pharmacological treatments, management of potential complications, and nursing interventions tailored to her specific needs.

Mental Health Diagnosis

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

Multiple factors contribute to Ivy’s depressive episode. Her psychosocial stressors, including divorce and a family history of depression, increase her vulnerability. Genetic predisposition is also a factor, as her mother and brother have a history of depression. Additionally, she has hypertension and has previously experienced depressive episodes, particularly during major life transitions, such as her youngest child leaving for college. She was prescribed venlafaxine, a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), but discontinued it due to withdrawal symptoms, potentially leading to her current relapse. Studies suggest that non-adherence to antidepressants is a key factor in the recurrence of depressive symptoms (Naudín et al., 2022).

Although Ivy’s symptoms were triggered by her divorce, her condition aligns more closely with 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 multifaceted 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

Conclusion

Ivy Jackson’s case highlights the multifaceted nature of Major Depressive Disorder (MDD). The structured concept map provides a clear breakdown of risk factors, symptoms, diagnostic approaches, pharmacological treatments, complications, and nursing interventions. Addressing MDD requires an integrated approach, combining psychological, physiological, and pharmacological factors to optimize treatment, improve patient adherence, and enhance overall mental well-being. A patient-centered care model that prioritizes individualized treatment, social support, and evidence-based interventions is essential for Ivy’s long-term recovery 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

NURS FPX 4015 Assessment 3

Naudín, M. A.-P., Abejón, E.-G., Gómez, F.-H., Lázaro, D.-F., & Álvarez, F. J. (2022). Non-adherence to antidepressant treatment and related factors in a region of Spain: A population-based registry study. Pharmaceutics, 14(12), 2696. https://doi.org/10.3390/pharmaceutics14122696

Remes, O. (2021). Biological, psychological, and social determinants of depression: A review of recent literature. Brain Sciences, 11(12), 1–33. https://doi.org/10.3390/brainsci11121633

NURS FPX 4015 Assessment 2

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date

Enhancing Holistic Nursing Care with the 3Ps

Holistic nursing care is a patient-centered approach that addresses the physical, emotional, social, and spiritual well-being of individuals. This comprehensive method ensures that healthcare providers do not merely focus on treating symptoms but rather aim to improve the overall health of patients. The foundation of holistic nursing care relies on three essential components: pathophysiology, pharmacology, and physical assessment, commonly known as the 3Ps. These domains equip nurses with the necessary knowledge and skills to deliver safe, effective, and individualized care. A deep understanding of the 3Ps enhances clinical decision-making, improves patient outcomes, and promotes high-quality nursing practice (Weeder, 2023). This discussion explores the significance of holistic nursing care, the role of the 3Ps in nursing practice, and the integration of these core concepts to optimize healthcare delivery.

The Importance of Holistic Nursing Care

Holistic nursing care recognizes that health is influenced by multiple factors beyond physical ailments, including psychological, social, and environmental elements. This approach fosters a compassionate, patient-centered relationship between nurses and their patients, allowing for a more personalized healthcare experience (AHNA, 2021). Through holistic nursing, patients benefit from improved treatment adherence, reduced stress, and enhanced overall well-being. Studies show that patients receiving holistic care experience better recovery rates due to the integration of complementary therapies such as mindfulness, therapeutic communication, and stress management techniques (Lukovsky et al., 2020).

For nurses, holistic care not only improves job satisfaction but also mitigates burnout by fostering deeper connections with patients. By addressing the emotional and spiritual aspects of care, nurses can develop a more fulfilling professional practice. Furthermore, holistic nursing enhances critical thinking and advocacy skills, ensuring that nurses provide comprehensive care that aligns with each patient’s unique needs. This approach ultimately leads to a higher standard of healthcare, where both patients and nurses thrive within a supportive and empathetic environment.

Integration of the 3Ps in Nursing Practice

The effective implementation of holistic nursing care is largely dependent on the integration of pathophysiology, pharmacology, and physical assessment. These three components form the foundation of clinical nursing practice and play a crucial role in patient safety and healthcare quality.

• Pathophysiology: Understanding the underlying mechanisms of diseases enables nurses to identify potential complications, recognize early symptoms, and implement timely interventions. For example, nurses caring for diabetic patients must comprehend insulin resistance and its systemic effects to provide appropriate lifestyle education and monitoring (Park, 2021).

• Pharmacology: Medication management is essential for ensuring effective treatment and preventing adverse effects. Nurses must be well-versed in drug classifications, mechanisms of action, and interactions to administer medications safely. Adhering to the “five rights” of medication administration helps prevent errors and enhances patient safety (Stolic et al., 2022).

• Physical Assessment: Conducting comprehensive physical examinations allows nurses to gather critical patient data, identify abnormalities, and tailor interventions accordingly. Physical assessment techniques such as auscultation, palpation, and neurological evaluations provide valuable insights into a patient’s condition and guide clinical decision-making (Patiwael et al., 2021).

By integrating these three components, nurses can deliver holistic, evidence-based care that prioritizes patient well-being while ensuring the safe and effective management of diseases.

Table: Role of the 3Ps in Holistic Nursing Care

Application of the 3Ps in Clinical Scenarios

The integration of pathophysiology, pharmacology, and physical assessment is critical in various clinical settings. For instance, in managing patients with chronic obstructive pulmonary disease (COPD), nurses must understand the inflammatory mechanisms that cause airway obstruction. This knowledge enables them to assess symptoms such as dyspnea and wheezing, administer bronchodilators effectively, and provide oxygen therapy when necessary (MacLeod et al., 2021).

Similarly, in cases of sepsis, nurses apply their knowledge of systemic inflammatory responses to monitor vital signs, recognize early signs of deterioration, and administer appropriate pharmacological treatments, including antibiotics and intravenous fluids. Comprehensive physical assessments help detect changes in skin perfusion, urine output, and blood pressure, allowing for timely interventions that can prevent organ failure (Thom et al., 2021).

By synthesizing the 3Ps in clinical practice, nurses can ensure that patient care is both holistic and evidence-based. This approach promotes a deeper understanding of disease management, enhances patient safety, and fosters a higher standard of nursing practice.

Conclusion

Holistic nursing care, supported by the integration of pathophysiology, pharmacology, and physical assessment, enhances the overall quality of healthcare by addressing the multifaceted needs of patients. By understanding disease processes, administering medications safely, and conducting thorough assessments, nurses can provide personalized, patient-centered care that improves health outcomes. The 3Ps serve as fundamental pillars in nursing education and practice, ensuring that nurses are equipped to meet the challenges of modern healthcare while maintaining a compassionate and holistic approach to patient care.

References

American Holistic Nurses Association (AHNA). (2021). What we do. American Holistic Nurses Association. https://www.ahna.org/About-Us/What-is-Holistic-Nursing

Lukovsky, J., McGrath, E., Sun, C., Frankl, D., & Beauchesne, M. A. (2020). A survey of hospice and palliative care nurses’ and holistic nurses’ perceptions of spirituality and spiritual care. Journal of Hospice & Palliative Nursing, 23(1), 28–37. https://doi.org/10.1097/njh.0000000000000711

MacLeod, M., Papi, A., Contoli, M., Beghé, B., Celli, B. R., Wedzicha, J. A., & Fabbri, L. M. (2021). Chronic obstructive pulmonary disease exacerbation fundamentals: Diagnosis, treatment, prevention and disease impact. Respirology, 26(6), 532–551. https://doi.org/10.1111/resp.14041

Park, J. J. (2021). Epidemiology, pathophysiology, diagnosis, and treatment of heart failure in diabetes. Diabetes & Metabolism Journal, 45(2), 146–157. https://doi.org/10.4093/dmj.2020.0282

NURS FPX 4015 Assessment 2

Patiwael, J. A., Douma, A. H., Bezakova, N., Kusurkar, R. A., & Daelmans, H. E. M. (2021). Collaborative testing in physical examination skills training and the autonomous motivation of students: A qualitative study. Biomed Central Medical Education, 21(1). https://doi.org/10.1186/s12909-021-02618-7

Stolic, S., Ng, L., & Sheridan, G. (2022). Electronic medication administration records and nursing administration of medications: An integrative review. Collegian, 30(1), 163–189. https://doi.org/10.1016/j.colegn.2022.06.005

Thom, R. P., Alexander, J. L., Baron, D., Garakani, A., Gross, L., Pine, J. H., Radhakrishnan, R., Slaby, A., & Sumner, C. R. (2021). Selective serotonin reuptake inhibitors: How long is long enough? Journal of Psychiatric Practice, 27(5), 361–371. https://doi.org/10.1097/pra.0000000000000578

Weeder, S. (2023). Preparing nurse practitioners to address planetary health and climate change. Nurse Educator, 48(6), e342. https://doi.org/10.1097/nne.0000000000001518

NURS FPX 4015 Assessment 1

Name

Capella University

NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care

Prof. Name

Date