During thrombolytic therapy for an acute myocardial infarction, which assessment should be reported immediately?

The appropriate assessment to report immediately during thrombolytic therapy for an acute myocardial infarction is a history of cerebral arteriovenous malformation. This is critical because the use of thrombolytics carries a risk of serious bleeding complications, particularly intracranial hemorrhage. In patients with a known history of cerebral vascular anomalies such as an arteriovenous malformation, the potential for such complications increases significantly. Immediate reporting of this information is crucial for the healthcare team to assess the risks and consider alternative interventions that may be more appropriate given the patient's medical history.

The other options, while they may warrant attention, do not present an immediate risk to the patient during thrombolytic therapy. For instance, menstruation is generally not a contraindication for thrombolytics, although it can lead to increased clotting take especially if there is already a more significant bleeding risk. A chest pain rating of 8 could indicate a need for pain management or further assessment but is not an immediate danger. A blood pressure of 170/92 mm Hg is elevated and may require monitoring and potential treatment, but it does not pose the same level of immediate concern as the risk of major bleeding associated with the history of a cerebral arteriovenous malformation.