When administering alteplase recombinant for a thrombus, what should the nurse observe for?

When administering alteplase recombinant, it is crucial for the nurse to closely monitor for signs of bleeding, as the medication is a thrombolytic agent used to dissolve clots. Bruising of the skin is a significant indicator of potential bleeding complications that can occur with thrombolytic therapy. This can happen because alteplase breaks down fibrin, which is critical for normal blood clot formation.

If bruising occurs, it may suggest that the patient is experiencing systemic bleeding, which can lead to more serious complications such as intracranial hemorrhage or gastrointestinal bleeding. Therefore, monitoring for bruising serves as an important assessment to ensure the patient's safety during treatment with alteplase.

The other options relate to conditions that might also be monitored but are not as directly indicative of the specific risks associated with thrombolytic therapy. High blood pressure could complicate the treatment but is not a direct sign of bleeding. Increased heart rate might suggest various conditions, including anxiety or pain, rather than a direct reaction to the drug. Chest pain could indicate a range of issues, including a recurrence of ischemia or complications from thrombolysis, but does not specifically reflect the bleeding risk that is critical in this context.