مريض لديه STEMI ومستشفى القسطرة بعيد، فقرر الطبيب إعطاء مذيب جلطة. أي معلومات في تاريخه تمنع إعطاء الدواء؟ (اختر كل ما ينطبق)

A client has a STEMI and the PCI centre is far away, so the physician plans thrombolysis. Which findings in his history contraindicate the drug? (Select all that apply)

1. His BP is 150/90 after treatment
2. Active GI bleeding with black stools today
3. Tearing back pain with a pressure difference between the arms
4. He is 72 years old and takes metformin
5. An ischaemic stroke two months ago

Answer: B) Active GI bleeding with black stools today, C) Tearing back pain with a pressure difference between the arms, E) An ischaemic stroke two months ago. Ischaemic stroke within 3 months, suspected aortic dissection and active bleeding are absolute contraindications. Age alone is not, and blood pressure contraindicates only when it remains severe and uncontrolled (for example above 180/110).