A nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which information, identified during history taking, would contraindicate this type of therapy?
a. The patient just completed her last men-strual cycle.
b. The patient states that the chest pain started 1 hour ago.
c. The patient has a history of a small cere-bral aneurysm.
d. The patient has hypertension that is well controlled by diuretic therapy.
C
Patients with a history of CVA should not receive fibrinolytic therapy. This patient has had a known cerebral aneurysm. Active internal bleeding is a contraindication for thrombolysis except for menses, but the patient has indicated she has completed her last cycle. Fibrinolytic therapy should be administered for chest pain that has been present for no longer than 12 hours. Poorly controlled or severe hypertension is a relative contraindication. Thrombolytics can be adminis-tered with caution.
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