Case scenario  Zack is a 67 year old white woman who brings tightness and chest discomfort, dyspnea, lightheadedness, and nausea to the emergency department.

Case scenario 

Zack is a 67 year old white woman who brings tightness and chest discomfort, dyspnea, lightheadedness, and nausea to the emergency department. Symptoms started a few of days ago, and have gradually deteriorated till now. He has family records of mothers: cardiovascular and paternal cancer, diabetes, stroke and cancer of the lung. The patient has Positive social history of 15 years of smoking. One year ago the patient stopped smoking cigarettes because of breathlessness and refuses all alcohol and drug use. No food or medicines allergies known. His medical history includes hyperlipidemia, infarction with myocardial tissue, tobacco, COPD, diabetes mellitus, vascular peripheral illness and obesity. Her current drugs consist of 25 mcg fluticasone inhaled daily, 2.5 mg or 4 times daily albuterol nebulizer, 20 mg oral medicines, 75 mg or more daily clopidogrel, 100 mg of BID cilostazol, and 500 mg BID metformin.

After evaluating the patient's health situation, dubious MI vs angina, smoking history, hyperlipidemia and diabetes, certain serious problems become obvious. Mr. Zack characterized the discomfort of the thorn as an atrocious, scorching pain that radiates over her chest. During the treatment with ER, two doses of nitroglycerin pills were used, and 2 L O2 per nasal cannula was used. She was brought to medical critical care for medical treatment of her chest pain after stabilization. During his medical study he was planned for the next day to receive a heart catherization with an advisable PCI to open the cardiovascular blockage of the right coronary artery of 90%. Mr. Zack's heart rate dropped to 35 beats per minute throughout the surgery, whereby atropine IV was given and the procedure proceeded successfully. Patient S was transported to the OT/telemetry unit on the day after the PCI.

Introduction

Transitional care includes a wide range of services and environments aimed at promoting the secure and timely transmission of patients between health levels and care facilities. For older persons with various chronic diseases and complex therapy regimes, and their family cares, high-quality transitional care is especially vital. Typically, these patients are cared after by several providers and often travel through medical facilities. An increasing number of studies show that they are especially prone to care failure and therefore have the highest need for transitional care (Camicia & Lutz, 2016). Poor "care" from hospital to home for elderly  persons and their families is related to negative occurrences, low care satisfaction, and high re-hospitalization levels. Many components influence to key shifts in care gaps. Ineffective leadership, insufficient information transmission, inadequate learning of older people and caregivers, lack of availability to critical services, and a single point person's absence, are all contributing to ensuring that care continues. The challenge is compounded by language and health education and cultural barriers (Naylor & Van Cleave, 2019).

 

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