The nurse is evaluating a patient admitted to the emergency department with an evolving STEMI for possible administration of thrombolytic therapy. Which of the following identified during history taking would contraindicate this type of therapy?
a. The patient just completed her last menstrual cycle.
b. The patient states that the chest pain started 1 hour ago.
c. The patient has a history of a small cerebral aneurysm.
d. The patient has hypertension that is well controlled by diuretic therapy.
C
The absolute contraindications to thrombolytic therapy include known structural cerebrovascular lesions. This patient has a known cerebral aneurysm.
Active internal bleeding is an absolute contraindication for thrombolysis except for menses, and the patient has indicated she has completed her last cycle. There is no contraindication to admin-istration.
Current guidelines indicate that thrombolytic therapy should be administered for chest pain that has been present for no longer than 12 hours. The patient meets this criterion for administration.
Although severe, poorly controlled hypertension is a relative contraindication, the patient's hypertension is well controlled by medication therapy. Thrombolytics can be administered with caution.
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