Categorize each action for a client with tricyclic-antidepressant overdose and a wide QRS complex as indicated or unsafe.
Matrix Multiple Choice
Choose your responses, then check the answer.
Explanation
Airway support, continuous ECG monitoring, poison-center consultation, seizure treatment, and sodium bicarbonate are indicated; physostigmine and class IA or IC antiarrhythmics are unsafe in this sodium-channel-blocker presentation.
Quick answer Treat the sodium-channel blockade and prevent seizures and dysrhythmias.
Why this is correct A wide QRS, hypotension, and seizures after a tricyclic overdose signal life-threatening sodium-channel blockade. Sodium bicarbonate and supportive toxicology care are prioritized.
Easy analogy or mental picture Open the blocked cardiac sodium highway; do not add another blocker.
Memory hook Wide QRS after TCA: bicarbonate and monitor.
NCLEX decision rule Match the antidotal strategy to the conduction mechanism and avoid drugs that worsen conduction or seizures.
Why the other choices are wrong Physostigmine can provoke dangerous complications in TCA overdose, and additional sodium-channel-blocking antiarrhythmics can worsen conduction.