Question

As a member of the stroke team, the nurse knows that thrombolytic therapy carries the potential for benefit and for harm. The nurse should be cognizant of what contraindications for thrombolytic therapy? Select all that apply.

A) INR above 1.0
B) Recent intracranial pathology
C) Sudden symptom onset
D) Current anticoagulation therapy
E) Symptom onset greater than 3 hours prior to admission

Answer 1

The contraindications for thrombolytic therapy that a nurse should be aware of include recent intracranial pathology, current anticoagulation therapy, and symptom onset greater than 3 hours prior to admission.

Step-by-step explanation:

Contraindications for thrombolytic therapy include several factors that could increase the risk of harm if this treatment is administered. The nurse on a stroke team should be cognizant of the following contraindications:

• B) Recent intracranial pathology such as a recent stroke or head injury.
• D) Current anticoagulation therapy, which might already impair clotting and enhance the risk of bleeding.
• E) Symptom onset greater than 3 hours prior to admission. The guidelines for thrombolytic therapy recommend administration within a specific time window, typically 3 to 4.5 hours, for maximal benefit and minimal harm.

Options A (INR above 1.0) and C (Sudden symptom onset) are not contraindications for thrombolytic therapy. Note that an INR above 1.0 may need to be considered in context, as it can be an indication of the patient's coagulation status; however, it is not a standalone contraindication.