Which symptom will the nurse encourage the patient taking ...

[abern]

Which symptom will the nurse encourage the patient taking flecainide to report to the health care provider?
 
  a. Headache
  b. Dizziness
  c. Constipation
  d. Weight gain

Question 2

A patient is admitted to the acute care telemetry unit with a diagnosis of atrial fibrillation. The physician orders dofetilide (Tikosyn). Before initiating this medication, the nurse will
 
  a. hold anticoagulant medications.
  b. remove ECG leads.
  c. assess potassium level.
  d. ensure QTc interval is more than 440 to 500 msec.

[allisonblackmore]

Answer to Question 1

ANS: D
Flecainide may induce or aggravate preexisting heart failure. Weight gain is a symptom of fluid retention; the patient should be instructed to contact the health care provider for further evaluation. Headache and constipation are not typical adverse effects. Dizziness is usually mild and tends to resolve with continued therapy.

Answer to Question 2

ANS: C
Hypokalemia must be corrected before initiation of dofetilide therapy. Before dofetilide (Tikosyn) is initiated on patients with atrial fibrillation, anticoagulation must occur. Patients with atrial fibrillation must be admitted to a unit with continuous ECG monitoring available. The QTc interval must be assessed; if it is more than 440 to 500 msec, dofetilide is contraindicated.