A client is being admitted for dofetilide initiation. Which actions belong in the nursing safety plan? Select exactly 4 responses.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Dofetilide must be initiated or reinitiated in a monitored facility using baseline QT, creatinine clearance, electrolyte correction, and serial ECG assessment.
Quick answer Prevent concentration-related QT prolongation and torsades.
Why this is correct Dofetilide labeling requires at least 3 days in a facility with continuous ECG monitoring, creatinine-clearance calculation, and cardiac resuscitation capability. Potassium must be normal and interacting drugs reviewed.
Easy analogy or mental picture The starting dose and each early QT check are guardrails on a narrow mountain road.
NCLEX decision rule Verify the monitored initiation algorithm rather than treating this as an ordinary outpatient prescription.
Why the other choices are wrong A wearable monitor does not replace the required facility, and early discharge can miss delayed QT-related risk.
References
1DailyMed: TIKOSYNInpatient initiation, QT and creatinine-clearance dosing, electrolyte correction, and torsades prevention
Dofetilide initiation bundleRecord baseline rhythm and QT, creatinine clearance, potassium and magnesium, interacting drugs, each dose, post-dose QT, conversion time, and discharge eligibility.