Category: Nursing

  • GERD

    GERD

    Mrs. Kaplan has been diagnosed with GERD.
    Mrs. Kaplan called Dr. Ferrari for a prescription refill of her medication. Her last prescription was written 4 months ago for Aciphex 20mg to be taken by mouth once a day for 4 weeks. Mrs. Kaplan is calling to get a refill of the same medication.

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    1. What further questions do you, the allied health professional, need to ask Mrs. Kaplan when she calls for a refill?

    2. Dr. Ferrari will not be available until tomorrow. Do you need to wait to call in the prescription?

    3. Why MIGHT Dr. Ferrari want to see Mrs. Kaplan prior to prescribing her medication?

    4. Document the phone call as you would in the medical record.

  • Use of the nursing process in making good nursing judgments essay

    Use of the nursing process in making good nursing judgments essay

    Using APA format, the information from this course, and your assigned readings write a six (6) to ten (10) page paper (excludes cover and reference page) addressing the application of the nursing process to a patient care scenario. Use these directions and the scoring rubric as you develop the paper. Outlines and abstracts are NOT required with this paper. Do not include the scenario in the Use of the nursing process in making good nursing judgments essay paper

    A minimum of three (3) current professional references must be provided excluding a nursing diagnosis book. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.

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    The Use of the nursing process in making good nursing judgments essay paper consists of three (3) parts:

    The meaning and use of the nursing process in making good nursing judgments
    that effect patient care

    The development of a plan of care using the nursing process for a specific patient situation

    The preparation stage for a teaching plan to prevent a recurrence of a similar situation

    The following sheet will assist you when composing the plan of care for the paper: Overview of the Nursing Process.

    Part 1 (3-4 pages)

    Review the required readings about the nursing process. In your own words, define each step of the process and provide an example for each step.

    In the implementation step, what is meant by direct and indirect care as described by the Nursing Intervention Classification (NIC) project?

    Discuss the three (3) types of nursing interventions (nurse-initiated, dependent, and interdependent) that applies to the patient care situation. Provide an example of each (refer to your textbook).

    Explain how the nursing process provides the basis for the registered nurse to make a nursing judgment that results in safe patient care with good outcomes.

    Discuss how the registered nurse evaluates the overall use of the nursing process. Identify three (3) variables that may influence the ability to achieve the desired outcomes for the patient.

    How is the plan of care modified when the outcomes are not met?

    How does the RN use the nursing process to make decisions about the priority of care?

    Part 2 (3 pages)

    Patient scenario

    A 78-year-old man is living in an assisted living facility. He is able to walk very short distances and uses a wheelchair to transport himself to the communal dining room. He administers his own medications independently and bathes himself. Over the last year he prefers to remain in the wheelchair even when in his room. He has a history of CHF, hypertension, hyperlipidemia and lower extremity weakness. He is able to state his current medications include metoprolol (Lopressor) 50 mg once daily by mouth, furosemide (Lasix) 20 mg once daily by mouth, Quinapril (Acupril) 20 mg once daily by mouth, atorvastatin (Lipitor) 20 mg once daily by mouth.

    During a routine examination, his physician noted a pressure ulcer over the ischium on the right buttocks. The wound is oval about 10mm x 8 mm, with red and yellow areas in the middle and black areas on some surrounding tissue. It has a foul odor. The patient had been padding the area so “it doesn’t get my pants wet”. The physician arranged for him to be admitted to the hospital in order for intravenous antibiotic therapy and wound care to be initiated. Use of the nursing process in making good nursing judgments essay. Use of the nursing process in making good nursing judgments essay.

    After being admitted to the hospital his medications are: metoprolol (Lopressor )50 mg orally every 12 hours, furosemide (Lasix ) 40mg once daily by mouth, quinapril HCl (Accupril) 40 mg once daily by mouth, cefazolin (Ancef)1.5 Grams in 50 mL 0.9 % Normal Saline intravenously three times a day. The result of the wound culture identified Methicilin-resistant staphylococcus aureus. After a surgical debridement of the black tissue a SilvaSorb® (antimicrobial gel) dressing was ordered daily.

    Develop a Plan of Nursing Care for this patient that includes all steps of the nursing process:

    One (1) actual NANDA-I nursing diagnosis addressing the priority problem the patient is experiencing. Provide a rationale, with evidence, why this nursing diagnosis is the priority for this patient.

    What is the assessment data that supports the use of this nursing diagnosis?

    One (1) expected outcome that addresses the diagnosis and meets the criteria for an expected patient outcome. Discuss whether the outcome is a cognitive, psychomotor, affective or physiologic outcome. Discuss why the time frame selected for the evaluative criteria was selected. Use evidence as the basis for the time frame and criteria.

    Four (4) nursing interventions that includes at least one (1) nurse-initiated, one (1) dependent, one (1) interdependent intervention. Label your interventions as above. Provide a rationale for each intervention that is evidence-based.

    Part 3 (1-2 pages)

    To assist the patient in preventing a recurrence of a similar incident once he returns to the assisted living environment, the RN needs to develop a teaching plan. Consider the information the RN would need prior to development of the plan. Respond to the following and be able to support your answers. You will not be developing a teaching-learning plan but demonstrating using the teaching-learning process to prepare for an individualized plan.

    How does the RN decide the format of the teaching plan, i.e., written, verbal, or other?

    How does the RN know which information needs to be included?

    When does the RN determine how and when to evaluate the teaching-learning process?

    Use of the nursing process in making good nursing judgments essay

  • Psychotherapy With Older Adults Essay Assignment Papers

    Psychotherapy With Older Adults Essay Assignment Papers

    According to the Institute of Medicine, more than 20% of the growing older adult population has a mental health disorder (IOM, 2012). In the past, many older adults avoided psychotherapy because of the associated social stigma, but with the growing acceptance of therapy and awareness of mental health issues, more of this population is seeking the help they need. In your role, as the psychiatric mental health nurse practitioner, you have the opportunity to help these older adult clients overcome challenges that may have plagued them for a lifetime.

    This week, as you explore psychotherapy with older adults, you assess clients and consider the appropriateness of various therapeutic approaches. You also examine the theories, goals, and objectives that guided your practicum experience throughout this course.

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    Psychotherapy With Older Adults Essay Assignment Papers Discussion: Clinical Supervision

    Personal reflection and discussion with colleagues is essential to your development as a psychiatric mental health nurse practitioner. In Week 8, you collaborated with colleagues as you participated in your first Clinical Supervision. This week, you have the opportunity to continue your collaboration as you reflect on and discuss your experiences with counseling older adults. Keep in mind that although there may be challenges to counseling this population, these clients offer unique learning opportunities. For this Clinical Supervision, consider an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

    Psychotherapy With Older Adults Essay Assignment Papers Learning Objectives

    Students will:

    Assess clients presenting for psychotherapy

    Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy

    To prepare:

    Review this week’s media and consider the insights provided.

    Reflect on the clients you are currently counseling at your practicum site.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking 
    Submit!

    By Day 3

    Post
     a 3- to 5-minute Kaltura video that addresses the following:

    Describe an older client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

    Note:
     Do not use the client’s actual name.

    Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.

    Identify any additional information about this client that may potentially impact expected outcomes.

    Note:
     Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

    View
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues by sharing additional insights or alternative perspectives. Support your feedback with evidence-based literature and/or your own experiences with clients.

    Note about uploading media:
     Refer to the 
    Kaltura Media Uploader
     instructions document, which provides guidance on how to upload media for the Clinical Supervision Discussions.

    Assignment 1: Practicum – Client Termination Summary – Psychotherapy With Older Adults Essay Assignment Papers

    Learning Objectives

    Students will:

    Develop client termination summaries

    To prepare:

    For guidance on writing a Client Termination Summary, review pages 693–712 of the Wheeler text in this week’s Learning Resources.

    Identify a client who may be ready to complete therapy.

    The Assignment

    With the client you selected in mind, address the following in a client termination summary (without violating HIPAA regulations):

    Identifying information of client (i.e., hypothetical name, age, etc.)

    Date initially contacted therapist, date therapy began, duration of therapy, and date therapy will end

    Total number of sessions, including number of missed sessions

    Termination planned or unplanned

    Presenting problem

    Major psychosocial issues

    Types of services rendered (i.e., individual, couple/family therapy, group therapy, etc.)

    Overview of treatment process

    Goal status (goals met, partially met, unmet)

    Treatment limitations (if any)

    Remaining difficulties and/or concerns

    Recommendations

    Follow-up plan (if indicated)

    Instructions for future contact

    Signatures

    By Day 7

    Submit
     your Assignment.

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK10Assgn1+lastname+first initial
    ”.

    Click the 
    Week 10 Assignment 1
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK10Assgn1+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

    Click on the 
    Submit
     button to complete your submission.

    Assignment 2: Practicum – Week 8 Journal Entry – Psychotherapy With Older Adults Essay Assignment Papers

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Evaluate the efficacy of existential-humanistic therapy for clients*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    Analyze clinical supervision experiences*

    *These Learning Objectives are related to the Assignment from Week 8.

    By Day 7

    Submit
     your Assignment. Refer to Week 8 for additional guidance.

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK10Assgn2+lastname+first initial
    ”.

    Click the 
    Week 10 Assignment 2
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK10Assgn2+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

     

    Assignment 3: Practicum – Week 9 Journal Entry – Psychotherapy With Older Adults Essay Assignment Papers

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    *These Learning Objectives are related to the Assignment from Week 9.

    By Day 7

    Submit
     your Assignment. Refer to Week 9 for additional guidance.

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK10Assgn3+lastname+first initial
    ”.

    Click the 
    Week 10 Assignment 3
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK10Assgn3+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

    Click on the 
    Submit
     button to complete your submission.

    Assignment 3: Practicum – Week 9 Journal Entry – Psychotherapy With Older Adults Essay Assignment Papers

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    *These Learning Objectives are related to the Assignment from Week 9.

    By Day 7

    Submit
     your Psychotherapy With Older Adults Essay Assignment Papers. Refer to Week 9 for additional guidance.

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK10Assgn3+lastname+first initial
    ”.

    Click the 
    Week 10 Assignment 3
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK10Assgn3+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

    Click on the 
    Submit
     button to complete your submission.

    Psychotherapy With Older Adults Essay Assignment Papers Week in Review

    Assessed clients presenting for psychotherapy

    Evaluated the effectiveness of therapeutic approaches for clients receiving psychotherapy

    Developed client termination summaries

    Analyzed how nursing and counseling theories guided personal practice in psychotherapy

    Evaluated goals and objectives for personal practicum experiences

    Analyzed the impact of psychotherapy on social change

    Psychotherapy With Older Adults Essay Assignment Papers

  • NURS561 Discussions Essay Assignments

    NURS561 Discussions Essay Assignments

    Week 2 Ethical Health Promotion Paper

    Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue. Use the WCU library databases to search for appropriate articles.

    In your paper:

    Briefly summarize the presented issue.

    Describe your thoughts on the role health care professionals should play in resolving the ethical issue.

    Provide specific theories and refer to specific ethical codes to support your position.

    Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper.

    Week 3 Community Strategic Plan: Part A, Community Assessment

    For this assignment, identify an area of focus in community health within your own community.

    Using Gordon’s Functional Health Patterns framework (p. 130 in your e-text), assess the health risks in your community.

    In your community assessment paper, include the following:

    Identify resources in your community that would enable you to complete a community assessment and submit a summary of your findings (1–2 paragraphs).

    Refer to Table 8-2: Examples of Community Strengths and Concerns, and assess the strengths and concerns of your community (2–3 paragraphs).

    Identify potential barriers to implementing community health plans in your community and brainstorm ways of addressing these barriers (2–3 paragraphs).

    Plan ahead: Next week, as Part B of this assignment, you will select one (1) identified risk from this assessment to develop a community-focused strategic plan to address that health risk. It is recommended that you look ahead to next week’s assignment so that you can begin framing your chosen community health focus.

    Your paper should be 2–3 pages in length, not including the cover and reference pages. Use APA throughout.

    You must include 2–3 sources that are APA cited and referenced in your paper. (Sources may include community resources such as flyers, brochures, interviews, news stories, and local research data from credible sources.)

    Review the rubric for further information on how your assignment will be graded.

    Week 4 Community Strategic Plan: Part B, Strategic Plan

    For this assignment, you will research and prepare a community-level strategic plan that addresses a key public health issue.

    Potential topics may include:

    • Using prenatal and infancy home visits to prevent child abuse and neglect

    • Preventing falls in the elderly

    • Reducing population salt intake

    • Reducing tobacco use among adults

    • Preventing risky sexual behavior among youth and young adults

    • Reducing drug experimentation among young adults

    Include the following in your paper:

    Introduction:

    Provide an overview of the community health issue as described in Part A with identified causes and influences, including knowledge gaps.

    Detail the prevalence of the issue inside and outside the United States.

    Describe potential monetary costs associated with the issue in the United States.

    You must include data as part of your introduction (images, charts, graphs, etc., may be included as well as written data).

    Describe advance practice roles and management strategies that affect change at the community level.

    Identify key community and social resources that negatively and positivelyaffect the selected issue.

    Identify changes or enhancements in community-related services for your selected topic.

    Develop a strategic plan that could decrease the prevalence of your selected topic.The goals for this plan needs to be specific, measurable, attainable, realistic, and time-bound. Include how your plan takes into consideration health literacy, socioeconomic factors, and cultural differences.

    NURS561 Discussions Essay Assignments

    Conclusion:

    A summary of the goals and challenges

    An assessment of the outlook for action/progress

    Appendix A: Include your community assessment from Week 3 as Appendix A.

    Your paper should be 3–5 pages in length (not including the cover or reference pages). Use APA throughout.

    Include 2–3 scholarly sources that are carefully selected and appropriate to the topic. References should be current—no more than four years old.

    Due: Sunday, 11:59 p.m. (Pacific time)

    Points: 110

    Review the rubric for further information on how your assignment will be graded.

    Before you begin, review some strategic plans to garner ideas for developing your own strategic plan.

    ACL strategic plan (2013–2018)

    A strategic plan to make improvements in the network of community-based long term care and supportive services for older adults and adults with disabilities in San Francisco

    Week 5 Disease Analysis Paper

    For this assignment, you will select a disease of your choice and conduct a detailed analysis of that disease, exploring it from a balanced traditional and alternative health perspective.

    Begin by searching the Center for Disease Control (CDC) website Diseases and Conditions Index to choose a disease or condition of interest to you.

    Next, review the website for Healthy People 2020 for information related to the disease or the disease category (e.g., mental health for ADHD).

    In your paper, discuss the following:

    Prominent aspects of this disease

    Current data and statistics related to the disease

    Health disparities related to the disease

    Prevention strategies including complementary and alternative health therapies

    Contemporary research and clinical studies related to the disease

    An analysis of the pathophysiologic effects of stress related to the disease

    Evidence-based stress management interventions that might help with prevention or cure

    The paper should be between 3–4 pages.

    Incorporate at least three scholarly sources within the paper. Sources should be no more than three years old.

    Use proper APA format to cite and reference sources.

    Review the rubric for further information on how your assignment will be graded.

    Due: Sunday, 11:59 p.m. (Pacific time)

    Week 7 Adolescent Health Risk Seminar

    For this assignment, you will develop and deliver a 10–15 minute seminar/workshop aimed at the teen or young adult audience on a specific health risk associated with the population. you will submit your presentation using the Kaltura recording tool within Blackboard. See the Getting Started with Kaltura link listed under the Resources area in your course menu to learn how to use this tool.

    * If you predominantly work with a specific population and would like to present a relevant health risk seminar to that population, you must seek instructor approval in advance. Email your instructor through the Virtual Office.

    1. Choose a health risk associated with adolescence. Some categories to consider may include:

    Suicide

    Pregnancy

    Substance use and abuse

    Motor vehicle crashes

    Tobacco use

    Sexually transmitted disease

    Domestic violence

    Mental health issues

    Sexual identity issues

    Eating disorders

    Nutrition and fitness

    2. As the health care advocate, you will present the following to the target audience (adolescents or young adults)in 10-15 slides or screens:

    An overview of the risk factor

    NURS561 Discussions Essay Assignments

    Contributing factors

    Prevalence of the health risk (meaningful data)

    Explain your role with the issue as a health care practitioner/advocate

    Ways to identify a problem and address the issue

    Present an activity or project or exercise for the audience to engage in related to the topic

    Help and support resources

    3. In your research materials, incorporate 3–4 current sources with one containing the most current statistics.

    4. Use age-appropriate creativity to ensure the message gets across to the selected audience.

    As you plan your seminar, consider:

    How will you initiate a conversation (rather than give a lecture)?

    How will you keep the attention and respect of this audience?

    5. Use APA for citing and referencing your sources.

    6. Keep your design and audio appropriate to the audience, yet professional. Your presentation must include both audio and visual components and be professional in nature.

    What is a seminar?

    See this week’s Resource folder for curriculum and topic ideas.

    Review the rubric for further information on how your assignment will be graded.

    Submit your final presentation here for grading and post a copy in the discussion board to share with your peers

    Due: Sunday, 11:59 p.m. (Pacific time)

    Points: 300

    Week 8 Global Health Risk Paper

    Choose a global health issue. For this assignment, you will introduce the health issue and discuss the interventions necessary to prevent the issue and promote health.

    Some topics to consider may include:

    Anthrax

    Bioterrorism

    Cholera

    Clostridium botulinum infection

    Community-associated methicillin-resistant Staphylococcus

    Ebola virus disease

    Escherichia coli

    Human immunodeficiency virus disease

    Malaria

    Plague

    Severe respiratory distress syndrome

    Small pox

    Suicide

    Tuberculosis

    Vancomycin-resistant enterococcus infection

    West Nile virus

    Include the following in your paper:

    Introduction/overview of the health issue and the prevalence in the United States and worldwide

    Contributing factors

    Prevention strategies

    Signs and symptoms

    Diagnostic tests (if applicable)

    Advanced practice nursing role and management strategies

    Medical/pharmacological management (if applicable)

    Follow-up care

    Conclusion

    Write a 3–4 page paper following APA format. You must include 2–3 scholarly sources in your citations and references.

    Review the rubric for further information on how your assignment will be graded.

    Due: Sunday, 11:59 p.m. (Pacific time)

    Points: 100

    NURS561 Discussions Essay Assignments

  • Psychotherapy With Children and Adolescents Essay Assignment Papers

    Psychotherapy With Children and Adolescents Essay Assignment Papers

    Approximately 1 in 5 children and adolescents have a mental health disorder, which may lead to issues at home, school, and other areas of their lives (Prout & Fedewa, 2015). When working with this population, it is important to recognize that children and adolescents are not “mini adults” and should not be treated as such. Psychotherapy with these clients is often more complex than psychotherapy with the general adult population, particularly in terms of communication. As a result, strong therapeutic relationships are essential to success.

    This week, as you explore psychotherapy with children and adolescents, you assess clients presenting with disruptive behaviors. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

    Discussion: Counseling Adolescents – Psychotherapy With Children and Adolescents Essay Assignment Papers

    The adolescent population is often referred to as “young adults,” but in some ways, this is a misrepresentation. Adolescents are not children, but they are not yet adults either. This transition from childhood to adulthood often poses many unique challenges to working with adolescent clients, particularly in terms of disruptive behavior. In your role, you must overcome these behaviors to effectively counsel clients. For this Discussion, as you examine the 
    Disruptive Behaviors
     media in this week’s Learning Resources, consider how you might assess and treat adolescent clients presenting with disruptive behavior.

    Psychotherapy With Children and Adolescents Essay Assignment Papers Learning Objectives

    Students will:

    Assess clients presenting with disruptive behavior

    Analyze therapeutic approaches for treating clients presenting with disruptive behavior

    Evaluate outcomes for clients presenting with disruptive behavior

    To prepare: Psychotherapy With Children and Adolescents Essay Assignment Papers

    Review this week’s Learning Resources and reflect on the insights they provide.

    View the media, 
    Disruptive Behaviors
    . Select one of the four case studies and assess the client.

    For guidance on assessing the client, refer to pages 137-142 of the Wheeler text in this week’s Learning Resources.

    Note:
     To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking 
    Submit!

    By Day 3

    Post
     an explanation of your observations of the client in the case study you selected, including behaviors that align to the criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.

    Assignment: Practicum – Week 9 Journal Entry – Psychotherapy With Children and Adolescents Essay Assignment Papers

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    * The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.

    Select a child or adolescent client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

    Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.

    Using the DSM-5, explain and justify your diagnosis for this client.

    Explain any legal and/or ethical implications related to counseling this client.

    Support your position with evidence-based literature.

    Psychotherapy With Children and Adolescents Essay Assignment Papers Week in Review

    Assessed clients presenting with disruptive behavior

    Analyzed therapeutic approaches for treating clients presenting with disruptive behavior

    Evaluated outcomes for clients presenting with disruptive behavior

    Developed diagnoses for clients receiving psychotherapy

    Analyzed legal and ethical implications of counseling clients with psychiatric disorders

    Psychotherapy With Children and Adolescents Essay Assignment Papers

  • How Illnesses and Injuries Affect the Mind Essay Assignment

    How Illnesses and Injuries Affect the Mind Essay Assignment

    Health complications can be stressful, especially in more vulnerable populations like young children and the elderly. With stress and loss of function often come depression and other psychological manifestations. As a nurse, part of your job is to recognize and educate patients and caregivers on how to deal with the psychological complications of a health crisis.

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    Develop a teaching plan for treating the potential psychological issues that may result from health crises in either the elderly or young children. You will use PowerPoint to present your teaching plan. Some considerations to make include:

    · In what ways does mental health need to be considered across the illness/injury continuum?

    · How can nurses help both patients and caregivers work through mental blocks and depression associated with an illness or injury?

    · Although treatment will take place in a medical facility, how can non-medical treatments be used as a supplement?

    Include the main elements of your presentation to a group of parents or elderly or their caregivers. This PowerPoint presentation should include between 8–10 slides. It will be assessed using the How Illnesses and Injuries Affect the Mind Rubric. Prior to submitting your How Illnesses and Injuries Affect the Mind Essay Assignment, make sure to review the rubric, which is located in the Course Information area.

    Writing Resources and Program Success Tools

    ·.waldenu.edu/bbcswebdav/institution/USW1/201830_03/BS_NURS/NURS_4005/artifacts/USW1_NURS_4005_AWE_Checklist_4000Level.docx” title=”AWE Checklist (Level 4000)”>AWE Checklist (Level 4000)

    This checklist will help you self-assess your writing to see if it meets academic writing standards for this course.

    ·For this Assignment, review the following:

    · AWE Checklist (Level 4000)

    · The Week 3 Assignment Rubric for additional instruction and guidance

    How Illnesses and Injuries Affect the Mind Essay Assignment

  • Existential-Humanistic Therapy Essay Assignments

    Existential-Humanistic Therapy Essay Assignments

    “It is the client who knows what hurts, what directions to go, what problems are crucial, what experiences have been deeply buried.”

    –Carl Rogers, from 
    On Becoming a Person

    This client-centered perspective is the cornerstone of existential-humanistic therapy, which requires therapists to “attempt to receive clients with curiosity and openness, endeavor to grasp their subjective world, and believe that clients are the experts on their own experience” (Wheeler, 2014, p. 373). As the psychiatric mental health nurse practitioner, it is important to understand that the effectiveness of this approach is dependent on your relationship with clients, as well as your beliefs on holism and human nature.

    This week, as you explore existential-humanistic therapy, you assess clients and consider the appropriateness of various therapeutic approaches. You also develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

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    Existential-Humanistic Therapy Essay Assignments Discussion: Clinical Supervision

    Clinical Supervision is an essential component of your development as a psychiatric mental health nurse practitioner. It provides an opportunity for professional collaboration as you share experiences with and gain insights from colleagues. For this Clinical Supervision, consider a client whom you do not think is adequately progressing according to expected clinical outcomes.

    Existential-Humanistic Therapy Essay Assignments Learning Objectives

    Students will:

    Assess clients presenting for psychotherapy

    Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy

    Apply existential-humanistic therapy to clients with psychiatric disorders

    To prepare:

    Review this week’s media and consider the insights provided.

    Reflect on the clients you are currently counseling at your practicum site.

    Note:
     For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking 
    Submit!

    By Day 3

    Post
     a 3- to 5-minute Kaltura video that addresses the following:

    Describe a client you are counseling whom you do not think is adequately progressing according to expected clinical outcomes.

    Note:
     Do not use the client’s actual name.

    Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.

    Identify any additional information about this client that may potentially impact expected outcomes.

    Note:
     Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills. When filming your Kaltura video, be sure to dress and speak in a professional manner.

    View
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues by providing feedback based on an existential-humanistic therapeutic perspective. Support your feedback with evidence-based literature and/or your own experiences with clients.

    Note about uploading media:
     Refer to the 
    Kaltura Media Uploader
     instructions document, which provides guidance on how to upload media for the Clinical Supervision Discussions.

    Existential-Humanistic Therapy Essay Assignments: Practicum – Week 8 Journal Entry

    This week, you complete a two-part journal entry.

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Evaluate efficacy of existential-humanistic therapy for clients*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    Analyze clinical supervision experiences*

    * The Existential-Humanistic Therapy Essay Assignments related to this Learning Objective is introduced this week and submitted in Week 10.

    For 
    Part 1
    , select a client whom you observed or counseled this week (other than the client used for this week’s Discussion). Then, address the following in your Practicum Journal:

    Describe the client and identify any pertinent history or medical information, including prescribed medications.

    Using the DSM-5, explain and justify your diagnosis for this client.

    Explain whether existential-humanistic therapy would be beneficial with this client. Include expected outcomes based on this therapeutic approach.

    Explain any legal and/or ethical implications related to counseling this client.

    Support your approach with evidence-based literature.

    For 
    Part 2
    , reflect on your clinical supervision experiences. Then, address the following in your Practicum Journal:

    How often are you receiving clinical supervision from your preceptor?

    What are the sessions like?

    What is the preceptor bringing to your attention?

    How are you translating these sessions to your clinical practice?

     

    Existential-Humanistic Therapy Essay Assignments Week in Review

    Assessed clients presenting for psychotherapy

    Evaluated the effectiveness of therapeutic approaches for clients receiving psychotherapy

    Applied existential-humanistic therapy to clients with psychiatric disorders

    Developed diagnoses for clients receiving psychotherapy

    Evaluated the efficacy of existential-humanistic therapy for clients

    Analyzed legal and ethical implications of counseling clients with psychiatric disorders

    Analyzed clinical supervision experiences

    Existential-Humanistic Therapy Essay Assignments

  • NUR641E – Compare and contrast the pathophysiology between chronic obstructive pulmonary disease (COPD) and pneumococcal pneumonia

    NUR641E – Compare and contrast the pathophysiology between chronic obstructive pulmonary disease (COPD) and pneumococcal pneumonia

    Compare and contrast the pathophysiology between chronic obstructive pulmonary disease (COPD) and pneumococcal pneumonia. Include any types of cellular injury or cellular adaptation that may occur. Evaluate if an inflammatory response is present and discuss the impact of that response. In the case of COPD, discuss the type of patient education you would implement to help with the patient’s understanding of the disease and to improve compliance with a treatment plan.

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    WEEK 4 DQ2 Find an evidence-based journal article on cystic fibrosis and summarize the article in one or two paragraphs. Address why you chose the article and how you might use the findings in your current or future practice setting.

  • Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Although supportive psychotherapy and interpersonal psychotherapy share some similarities, these therapeutic approaches have many differences. When assessing clients and selecting therapies, it is important to recognize these differences and how they may impact your clients. For this Assignment, as you compare supportive and interpersonal psychotherapy, consider which therapeutic approach you might use with your clients.

    Learning Objectives

    Students will:

    Compare supportive psychotherapy and interpersonal psychotherapy

    Recommend therapeutic approaches for clients presenting for psychotherapy

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    To prepare:

    Review the media in this week’s Learning Resources.

    Reflect on supportive and interpersonal psychotherapeutic approaches.

    The Assignment – Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    In a 1- to 2-page paper, address the following:

    Briefly describe how supportive and interpersonal psychotherapies are similar.

    Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.

    Explain which therapeutic approach you might use with clients and why. Support your approach with evidence-based literature.

    Note:
     The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at 
    http://academicguides.waldenu.edu/writingcenter/templates
     ). All papers submitted must use this formatting.

    By Day 7

    Submit
     your Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.

    Click the 
    Week 7 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 7 Assignment 1 
    link. You will also be able to “View Rubric” for grading criteria from this area.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click 
    Open
    .

    If applicable: From the Plagiarism Tools area, click the checkbox for 
    I agree to submit my paper(s) to the Global Reference Database
    .

    Click on the 
    Submit
     button to complete your submission.

    Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Supportive and Interpersonal Psychotherapy – Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Amelia, a 16-year-old high school sophomore, presents with symptoms of weight loss and a very obvious concern for her weight. She has made several references to being “fat” and “pudgy” when, in fact, she is noticeably underweight. Her mother reports that she is quite regimented in her eating and that she insists on preparing her own meals as her mother “puts too many fattening things in the food” that she cooks. After discovering that during the past 3 months Amelia has lost 15 pounds and is well under body weight for someone of similar age/sex/developmental trajectory, the psychiatric mental health nurse practitioner diagnosed Amelia with anorexia nervosa.

    Evidence-based research shows that clients like Amelia may respond well to supportive psychotherapy and interpersonal psychotherapy. So which approach might you select? Are both equally effective for all clients? In practice, you will find that many clients may be candidates for both of these therapeutic approaches, but factors such as a client’s psychodynamics and your own skill set as a therapist may impact their effectiveness.

    This week, you continue exploring therapeutic approaches and their appropriateness for clients as you examine supportive psychotherapy and interpersonal psychotherapy. You also assess progress for a client receiving psychotherapy and develop progress and privileged psychotherapy notes for the client.

    Assignment 2: Practicum – Assessing Client Progress

    Learning Objectives

    Students will:

    Assess progress for clients receiving psychotherapy

    Differentiate progress notes from privileged notes

    Analyze preceptor’s use of privileged notes

    To prepare:

    Reflect on the client you selected for the Week 3 Practicum Assignment.

    Review the Cameron and Turtle-Song (2002) article in this week’s Learning Resources for guidance on writing case notes using the SOAP format.

    The Assignment – Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Part 1: Progress Note

    Using the client from your Week 3 Assignment, address the following in a progress note (without violating HIPAA regulations):

    Treatment modality used and efficacy of approach

    Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the Treatment plan—progress toward goals)

    Modification(s) of the treatment plan that were made based on progress/lack of progress

    Clinical impressions regarding diagnosis and/or symptoms

    Relevant psychosocial information or changes from original assessment (i.e., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job, etc.)

    Safety issues

    Clinical emergencies/actions taken

    Medications used by the patient (even if the nurse psychotherapist was not the one prescribing them)

    Treatment compliance/lack of compliance

    Clinical consultations

    Collaboration with other professionals (i.e., phone consultations with physicians, psychiatrists, marriage/family therapists, etc.)

    Therapist’s recommendations, including whether the client agreed to the recommendations

    Referrals made/reasons for making referrals

    Termination/issues that are relevant to the termination process (i.e., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)

    Issues related to consent and/or informed consent for treatment

    Information concerning child abuse, and/or elder or dependent adult abuse, including documentation as to where the abuse was reported

    Information reflecting the therapist’s exercise of clinical judgment

    Note:
     Be sure to exclude any information that should not be found in a discoverable progress note.

    Part 2: Privileged Note

    Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client from the Week 3 Practicum Assignment.

    The privileged note should include items that you would not typically include in a note as part of the clinical record.

    Explain why the items you included in the privileged note would not be included in the client’s progress note.

    Explain whether your preceptor uses privileged notes, and if so, describe the type of information he or she might include. If not, explain why.

    By Day 7

    Submit
     your Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK7Assgn2+lastname+first initial
    ”.

    Click the 
    Week 7 Assignment 2
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK7Assgn2+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

    Click on the 
    Submit
     button to complete your submission.

    Assignment 3: Practicum – Week 5 Journal Entry

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Evaluate the efficacy of therapeutic approaches for clients*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    *These Learning Objectives are related to the Assignment from Week 5.

    By Day 7

    Submit
     your Assignment. Refer to Week 5 for additional guidance.

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK7Assgn3+lastname+first initial
    ”.

    Click the 
    Week 7 Assignment 3
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK7Assgn3+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

    Click on the 
    Submit
     button to complete your submission.

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    Assignment 4: Practicum – Week 6 Journal Entry

    Learning Objectives

    Students will:

    Develop diagnoses for clients receiving psychotherapy*

    Evaluate the efficacy of motivational interviewing techniques for clients*

    Analyze legal and ethical implications of counseling clients with psychiatric disorders*

    *These Learning Objectives are related to the Assignment from Week 6.

    By Day 7

    Submit
     your Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers. Refer to Week 6 for additional guidance.

    Submission

    To submit your completed Assignment for review and grading, do the following:

    Please save your 
    Assignment
     using the following naming convention: “
    WK7Assgn4+lastname+first initial
    ”.

    Click the 
    Week 7 Assignment 4
     link.

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “
    WK7Assgn4+last name+first initial.(extension)
    ” and click 
    Open
    . If you are submitting multiple files, repeat until all files are attached.

    Click on the 
    Submit
     button to complete your submission.

    Week in Review

    Compared supportive psychotherapy and interpersonal psychotherapy

    Recommended therapeutic approaches for clients presenting for psychotherapy

    Assessed progress for clients receiving psychotherapy

    Differentiated progress notes from privileged notes

    Analyzed preceptor’s use of privileged notes

    Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

    Supportive versus interpersonal psychotherapy

    Introduction

    Psychotherapy refers to a broad range of treatment strategies applied psychiatric management that involve changing the brain chemistry and thought process without using chemical agents. It typically requires the intervention of a therapist who acts as a mediator and uses professional knowledge as well as skills to direct the treatment with a focus on developing a personalized solution for the client. Through psychotherapy, the client receives treatment that revolve around developing healthier habits, better personality and socially acceptable thought processes. It is important to note that psychotherapy presents many treatment options and should one option fail, then another option would be considered. In addition, it is not uncommon for psychotherapy to be complemented with pharmacotherapy for the best treatment outcome (Shea, 2015). The present discusses the similarities and differences between supportive psychotherapy and interpersonal psychotherapy as two examples of psychotherapy approaches.

    Discussion

    Briefly describe how supportive and interpersonal psychotherapies are similar.

    Supportive and interpersonal psychotherapy have some describable similarities. The first similarity is that the two psychotherapy approaches apply talk therapy whereby the therapist acts as a mediator and engages the client in a conversation to identify and discuss the underlying problem with a view to presenting and applying a personalized solution that best fits the client’s needs Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers. The second similarity is that the two therapies require the client to actively participate in the therapy. This aspect focuses on the client’s willingness to have a solution for the existing problem, acknowledging that a problem exists and it should be addressed through honest expression before it worsens. The third similarity is that the client must not only acknowledge the existence of a problem and be willing to discuss the problem, but must also be willing to apply the developed solution while offering feedback to improve the solution’s adaptability as the actual situation demands (Thompson, 2016).

    Explain at least three differences between these therapies. Include how these differences might impact your practice as a mental health counselor.

    Although supportive and interpersonal psychotherapies share some similarities as discussed, the two approaches are fundamentally different. Firstly, the two approaches have the therapist and client playing different roles during the process of treatment. In supportive psychotherapy, the therapist directs the client, actively informing the client on what to do to address the problem. Even as the therapist plays an active role, the client takes on a passive role since he/she does not develop the solution but simply applies it as presented. In interpersonal psychotherapy, the therapist takes on a passive role of ensuring that the patient develops and applies a solution that focuses on a general direction without specifics. Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers. The client takes on an active role to develop the solution and apply it while being guided by the client to act within acceptable frameworks. Secondly, the two therapies have different treatment boundaries. In supportive psychotherapy, the therapeutic relationship only exists during the treatment sessions to imply that it does not exist outside the treatment sessions. In interpersonal psychotherapy, the therapeutic relationship begins when the client is accepted into therapy and only ends when the client is released or discharged. This implies that the relationship exists even when the client is at home or on any other activity outside scheduled therapy sessions. Thirdly, the two therapies have the therapist applying different approaches. In supportive psychotherapy, the therapist acts as a model of the ideal expected of the client. In interpersonal psychotherapy, the therapist acts as a guide that guides the client in interpreting what is considered an ideal (Ruben, 2015).

    Explain which therapeutic approach you might use with clients and why.

    Interpersonal psychotherapy is preferable to supportive psychotherapy. That is because interpersonal psychotherapy presents comprehensive intervention that allows the client to apply a personalized solution that can be evaluated inside and outside therapy. In addition, it incorporates the client’s perspective thus making the solution easier to apply. Although supportive therapy also offers a solution, it is confined to the therapy sessions thus making it difficult to evaluate the solution in terms of effectiveness. Also, it largely ignores the patient’s perspective thus making the solution harder to apply (Sperry, 2016). Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers.

    Conclusion

    One must accept that psychotherapy presents a range of tools for addressing psychiatric issues. In addition, one must acknowledge that two tools available under the definition of psychotherapy are interpersonal therapy and supportive therapy that have similarities and differences. Between the two therapies, interpersonal therapy is the better option since it presents comprehensive solutions with personalized approaches that can be evaluated outside the therapy sessions and incorporate the client’s perspective.

    References

    Ruben, D. (2015).
    Behavioral guide to personality disorders (DSM-5)
    . Springfield, IL: Charles C Thomas Publisher, Ltd.

    Shea, D. (2015).
    Cognitive behavioral approaches for counselors
    . Thousand Oaks, CA: SAGE Publications.

    Sperry, L. (2016).
    Handbook of diagnosis and treatment of DSM-5 personality disorders:
    assessment, case conceptualization, and treatment
    (3
    rd
    ed.). New York, NY: Routledge.

    Thompson, R. (2016).
    Counseling techniques: improving relationships with others, ourselves, our families, and our environments
    (3
    rd
    ed.). New York, NY: Routledge. Supportive Psychotherapy Versus Interpersonal Psychotherapy Essay Assignment Papers

  • Payer–patient mix for a health care organization case study

    Payer–patient mix for a health care organization case study

    Search course materials, including your text and the Internet, to find a spreadsheet program that will assist you in completing this assignment. The spreadsheet and calculations are to be attached at the end of the paper as an appendix after the Reference page.

    Case Study: You are assessing the payer–patient mix for a health care organization. Currently, your payer mix is 40% Medicare, 10% Medicaid, 25% traditional indemnity insurance, 20% managed care, and 5% self-pay patients. Complete the following:

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    Using the most common office visit, CPT code 99214, determine the reimbursement from the Centers for Medicare and Medicaid Services (online fee schedule available for Medicare).

    Using the same CPT code, 99214, determine the reimbursement for Medicaid (fee schedules should be available from the individual state).

    Using the same CPT code, 99214, create at least 3 other traditional indemnity insurance reimbursements. If possible, use the actual reimbursement from the insurance carrier. It may be possible to obtain actual reimbursement information from your personal insurance carrier. If the information is not available, assume reimbursement by traditional indemnity insurance is usually 200% reimbursed more than Medicare and Medicaid, and managed care is usually 133% more than Medicare and Medicaid.

    Compose an accounts receivable benchmark from this information showing columns for current, 30–60, 61–90, 90–120, and greater than 120 days.

    Assess the information for areas of improved reimbursement of at least 20% or more.

    Evaluate the options available to change the payer–patient mix with consideration of related legal and ethical issues.

    Propose a best strategy with justification and rationale based on effective decision-making tenets.

    The body of the resultant paper should be 10–12 pages. Spreadsheets demonstrating the accounts receivable analysis will be attached as appendices, and there will be at least 7 relevant peer-reviewed academic or professional references published within the past 5 years. Also attach appropriate fee schedules.

    Search course materials, including your text and the Internet, to find a spreadsheet program that will assist you in completing this assignment. The spreadsheet and calculations are to be attached at the end of the paper as an appendix after the Reference page.

    Case Study: You are assessing the payer–patient mix for a health care organization. Currently, your payer mix is 40% Medicare, 10% Medicaid, 25% traditional indemnity insurance, 20% managed care, and 5% self-pay patients. Complete the following:

    Using the most common office visit, CPT code 99214, determine the reimbursement from the Centers for Medicare and Medicaid Services (online fee schedule available for Medicare).

    Using the same CPT code, 99214, determine the reimbursement for Medicaid (fee schedules should be available from the individual state).

    Using the same CPT code, 99214, create at least 3 other traditional indemnity insurance reimbursements. If possible, use the actual reimbursement from the insurance carrier. It may be possible to obtain actual reimbursement information from your personal insurance carrier. If the information is not available, assume reimbursement by traditional indemnity insurance is usually 200% reimbursed more than Medicare and Medicaid, and managed care is usually 133% more than Medicare and Medicaid.

    Compose an accounts receivable benchmark from this information showing columns for current, 30–60, 61–90, 90–120, and greater than 120 days.

    Assess the information for areas of improved reimbursement of at least 20% or more.

    Evaluate the options available to change the payer–patient mix with consideration of related legal and ethical issues.

    Propose a best strategy with justification and rationale based on effective decision-making tenets.

    The body of the resultant paper should be 10–12 pages. Spreadsheets demonstrating the accounts receivable analysis will be attached as appendices, and there will be at least 7 relevant peer-reviewed academic or professional references published within the past 5 years. Also attach appropriate fee schedules.

    Payer–patient mix for a health care organization case study