Prior to initiating streptokinase therapy for a client with pulmonary embolism, which crucial finding should be reported?

In the context of initiating streptokinase therapy for a patient with a pulmonary embolism, it is pivotal to monitor the patient's blood pressure closely. A blood pressure reading of 198/110 mm Hg indicates significant hypertension, which is critical to report prior to starting thrombolytic therapy.

Streptokinase is a thrombolytic medication that can lead to serious complications, including bleeding, especially if the patient has uncontrolled hypertension. Elevated blood pressure may increase the risk of hemorrhagic events when thrombolytics are used, as these medications work by breaking down blood clots, which can exacerbate bleeding in areas where blood vessels may already be under pressure due to existing high blood pressure.

While other findings like adventitious breath sounds, a mild fever, or an elevated respiratory rate can also be significant, they do not present the same immediate risks associated with the initiation of streptokinase therapy as uncontrolled hypertension does. Therefore, the blood pressure reading must be reported and addressed to ensure the safety of the patient before proceeding with treatment.