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exactly when this return visit is scheduled and be aware of its importance. In addition, he should know exactly whom to contact if he has any questions regarding his condition. If he has been given a vitamin K preparation to use as an antidote he should understand fully under what circumstances it is to be used. Last but not least, it is advisable that he be issued an American Heart Association card to carry, which shows he is on anticoagulant therapy. This is important should he become ill or fall prey to an accident where a physician unfamiliar with his case would be required to give emergency care. A small percentage of the patients who survive the acute phase of their first myocardial infarction never do too well and continue to experience pain and dyspnea with the most restricted ambulation schedules. It behooves the professional nurse, as well as the doctor, to determine how much of this situation is associated with emotional difficulties. Certainly this is true for some of these patients. With the adequate handling of these problems the number of persons continuing as cardiac cripples can be reduced even further. Fortunately, most patients who survive this period return to an active life; some even assume positions of great responsibility, full of strife and stress. Nevertheless, the nurse should realize that as the patient reaches the end of his postacute phase, well armed with advice on how to plan his activities and take his medications, his concerns about himself, his family, and his future may grow more intense. During his hospitalization, he was probably primarily preoccupied with his physical well-being. Now, as he prepares to return home and resume normal living, problems associated with the sociological, psychological, and occupational spheres of his life are likely to assume increasing importance. The nurse cannot wait until the day before discharge, however, to help him cope with these problems. She must anticipate their subtle development, early in the course of the illness, and-through interpretation, understanding, and support-assist the patient to work his way through to realistic solutions. oble s the number of persons continuing as cripples can be reduced even further. ately, ost patients who survi e this period |
