What recent medical history increases the risk for a client receiving alteplase in the event of an acute myocardial infarction?

Receiving alteplase, a thrombolytic agent, during an acute myocardial infarction requires consideration of recent medical history, particularly any events that could heighten the risk of bleeding. Recent hip arthroplasty is significant in this context because it involves recent surgical intervention and potential for residual bleeding risk due to disrupted vascular integrity and compromised hemostasis.

After hip surgery, there can be an increased risk of bleeding into the surgical site or other areas, making the use of thrombolytics potentially hazardous. Alteplase dissolves blood clots, but it can also cause bleeding complications, especially in patients with a recent history of major surgery.

The other options, while relevant to a patient's cardiac history or overall health, do not present the immediate, significant bleeding risks associated with recent major surgeries like hip arthroplasty. Stable angina and previous coronary artery bypass surgery indicate prior cardiac issues but are not directly associated with an increased risk for bleeding in the context of thrombolytic therapy. Controlled hypertension is a chronic condition that can be managed and does not inherently pose an immediate bleeding risk compared to recent surgical interventions.