A client who ingested a large amount of extended-release bupropion is awake but agitated and tachycardic. Which action should the nurse take first?
1Start seizure precautions and ECG monitoring; contact the poison center.✓ Correct answer
2Discharge the client because no seizure has occurred yet.
3Give the next scheduled bupropion dose to prevent withdrawal.
4Administer flumazenil as the specific bupropion antidote.
Explanation
Extended-release bupropion overdose can produce delayed seizures, conduction abnormalities, dysrhythmias, and cardiovascular collapse; there is no specific antidote.
Quick answer Prepare for delayed seizures and dysrhythmias.
Why this is correct The label reports seizures in about one third of overdose cases plus conduction disturbances, arrhythmias, cardiac failure, and arrest. Close monitored supportive care is required.
Easy analogy or mental picture A quiet fuse can still lead to a delayed electrical storm.
Memory hook Bupropion overdose: monitor brain and heart.
NCLEX decision rule Do not use current wakefulness to exclude delayed extended-release toxicity.
Why the other choices are wrong Discharge, redosing, and flumazenil do not address the known bupropion overdose pattern.
References
1DailyMed: Wellbutrin XLOverdose seizures, conduction disturbances, dysrhythmias, and supportive monitoring