A nurse is discussing fibrinolytic therapy for the acute phase of STEMI management with a group of nursing students. Which statement by a student indicates understanding of this therapy?
a. "Fibrinolytics are effective when the first dose is given up to 24 hours after symp-tom onset."
b. "Fibrinolytics should be given once car-diac troponins reveal the presence of STEMI."
c. "Fibrinolytics should be used with caution in patients with a history of cerebrovascu-lar accident."
d. "Patients should receive either an anti-coagulant or an antiplatelet agent with a fibrinolytic drug."
C
Patients with a history of cerebrovascular accident (CVA) should not receive fibrinolytic agents because of the increased risk of intracranial hemorrhage. Fibrinolytics are most effective when given within 30 minutes of arrival in the emergency department. Because cardiac troponins are not detectable until 2 to 4 hours after the onset of symptoms, fibrinolytics should be administered before these laboratory values are available. Patients receiving fibrinolytics should receive both an anticoagulant and an antiplatelet drug.
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