Tissue plasminogen activator administration and nursing considerations.
Intravenous thrombolytic therapy is rapidly gaining acceptance in the care of acute myocardial infarction (AMI) patients. There are several thrombolytic agents in use; however, this article will focus on tissue type plasminogen activator (t-PA). A thorough understanding of the benefits and risks associated with thrombolytic administration will be critical in the successful utilization of this form of therapy. Recent data show that infarct size is linked to mortality. In the 1980s, therapy for acute myocardial infarction patients is directed at salvaging myocardium and limiting infarct size. Prior to this, therapy consisted mainly of supportive care that resulted only in minor effects on the patients prognosis. Intracoronary thrombus has recently been recognized as the cause in most cases of acute myocardial infarction. Thrombolytic therapy represents a method of dissolving a thrombus and reestablishing blood flow to the previously occluded coronary artery. Early reperfusion of ischemic myocardial tissue can limit the amount of damage caused by evolving myocardial infarction. Intervention with thrombolytic therapy in the early hours of acute myocardial infarctions has been associated with reduction in the infarct size, improvement in left ventricular function and reduction in mortality. Nursing plays a critical role in ensuring the successful use of thrombolytic therapy by early identification of appropriate patients and accurate administration of the thrombolytic agent.
Greco
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D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy / Q000451:nursing*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D010959:Tissue Plasminogen Activator