Cardiac-Vascular Nursing (CVRN) Practice Exam

What is the primary consideration when preparing to administer thrombolytic therapy for an acute myocardial infarction (MI)?

1. History of heart disease.

2. Size and location of the MI.

3. Sensitivity to aspirin.

4. Time since onset of symptoms.

The correct answer is: Sensitivity to aspirin.

When preparing to administer thrombolytic therapy for an acute myocardial infarction, the primary consideration is the time since the onset of symptoms. Timeliness is critical in achieving the best outcomes with thrombolytics because these medications are most effective when given within a specific window following the onset of ischemic symptoms. The goal is to restore blood flow as quickly as possible to minimize myocardial damage. Thrombolytics work by dissolving blood clots that obstruct coronary arteries, and their efficacy decreases significantly as time passes following the onset of the infarction. If administered too late, the risk of bleeding complications increases, and the likelihood of salvaging ischemic myocardial tissue diminishes. Thus, determining the time since symptoms started is crucial in decision-making for this therapy. While other factors, such as history of heart disease and the size and location of the myocardial infarction, may inform the overall management plan, they do not take precedence over the critical importance of timing in the context of thrombolytic therapy. Sensitivity to aspirin is not a primary concern in this context since thrombolytic agents are different from aspirin and their appropriateness is weighed on other clinical criteria.