# Place the nursing actions in order for suspected flecainide overdose with hypotension and a rapidly widening QRS complex.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=515772&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

Place the nursing actions in order for suspected flecainide overdose with hypotension and a rapidly widening QRS complex.

Activate emergency support and assess airway, breathing, circulation, and mental status.

Administer prescribed sodium bicarbonate while monitoring QRS width, pH, sodium, and potassium.

Place the client on continuous ECG and obtain immediate hemodynamic and laboratory data.

Reassess QRS width, rhythm, blood pressure, perfusion, pH, and electrolytes after treatment.

Notify the poison center and resuscitation team that a sodium-channel blocker is suspected.

## Explanation

Stabilize first, define the conduction and hemodynamic emergency, mobilize toxicology support, administer authorized sodium bicarbonate, and trend response and treatment complications.

## In-depth explanation

Quick answer
Treat flecainide overdose as life-threatening sodium-channel blockade.

Why this is correct
The label describes extreme QRS widening, ventricular tachycardia, block, hypotension, and arrest without a specific antidote. AHA poisoning guidance supports sodium bicarbonate for life-threatening sodium-channel-blocker dysrhythmias.

Easy analogy or mental picture
Open the sodium highway while continuously checking whether conduction and perfusion recover.

Memory hook
Wide QRS plus flecainide: ABCs, ECG, toxicology, bicarbonate, reassess.

NCLEX decision rule
Sequence stabilization, mechanism recognition, therapy, and response evaluation.

Why the other choices are wrong
Waiting for arrest or adding another sodium-channel blocker increases risk.References
1DailyMed: Flecainide AcetateOverdose conduction widening, hypotension, ventricular dysrhythmia, and absence of a specific antidote
2AHA Focused Update: Life-Threatening PoisoningPoison-center consultation, sodium bicarbonate, and high-dose insulin recommendations

## Clinical scenario

Flecainide overdose sequence
Use continuous ECG, hemodynamic support, toxicology consultation, authorized bicarbonate, and serial electrolyte and pH monitoring.

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