American Association of Critical-Care Nurses (AACN) Certification Practice Test

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What is an absolute contraindication to fibrinolysis?

  1. History of transient ischemic attack

  2. Severe hypertension (BP >180/110)

  3. Age over 70 years

  4. Diabetes mellitus

The correct answer is: Severe hypertension (BP >180/110)

Severe hypertension, defined as a blood pressure reading greater than 180/110 mmHg, is considered an absolute contraindication to fibrinolysis. This is because elevated blood pressure increases the risk of hemorrhagic complications, particularly in the context of administering fibrinolytic therapy. Fibrinolytics work by breaking down clots, but in a patient with severely high blood pressure, the likelihood of bleeding, particularly intracranially, escalates significantly. In cases of severe hypertension, the potential benefits of fibrinolysis are overshadowed by the risks associated with uncontrolled blood pressure. Managing blood pressure appropriately before considering fibrinolytic therapy is crucial to ensure patient safety. This contraindication is established in clinical guidelines to prevent adverse outcomes related to bleeding risks associated with fibrinolysis in patients with significant hypertension.

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