In a client receiving alteplase for an acute myocardial infarction, which intervention is a priority?

In the context of administering alteplase for an acute myocardial infarction, monitoring for signs of bleeding is a priority intervention. Alteplase is a thrombolytic agent, which means it works by dissolving blood clots that are obstructing blood flow to the heart muscle. While this medication can be life-saving by restoring blood flow, it also significantly increases the risk of bleeding, both internally and externally.

When administering alteplase, healthcare providers must be vigilant for signs that may indicate bleeding complications, such as unusual bruising, blood in urine or stool, or any sudden changes in neurological status. This is crucial because prompt identification and management of bleeding can prevent serious complications and improve patient outcomes.

While the other options do hold clinical significance, they do not have the immediate urgency that monitoring for bleeding does in the context of thrombolytic therapy. Monitoring psychosocial status and renal function, as well as having heparin available, are important considerations but they are secondary to the immediate risk of bleeding associated with alteplase therapy.