NCLEX Practice Test

Which complication is a contrainidication for thrombolytic therapy in a client?

1. Gallbladder surgery within 2 months

2. Loss of the gag reflex

3. Platelet count of 130,000/mm³

4. Symptoms started 12 hours earlier

The correct answer is: Gallbladder surgery within 2 months

Thrombolytic therapy is a medical treatment used to dissolve blood clots, and certain conditions can make this therapy risky or contraindicated. One significant contraindication for thrombolytic therapy is recent surgery, particularly major surgeries. Gallbladder surgery within the past 2 months raises concern over the risk of bleeding, as tissue healing may still be occurring and the risk of hemorrhage could be increased if thrombolytics are administered. Other options present risks, but they do not categorically contraindicate the use of thrombolytics as strongly as recent surgery does. Loss of the gag reflex indicates a risk for aspiration but is not a direct contraindication. A platelet count of 130,000/mm³, while lower than normal, does not automatically exclude the use of thrombolytics since it does not reach levels typically associated with serious bleeding risks. Symptoms starting 12 hours earlier may suggest the patient is still within the window for thrombolytics, which can be given up to 3 to 4.5 hours after symptom onset, depending on specific guidelines and clinical judgment. Thus, recent gallbladder surgery is the most critical factor that would preclude the use of thrombolytic therapy in this scenario.