A client is started on sotalol (Betapace) for conversion of atrial fibrillation. Which finding requires immediate nursing action?
1. A widening of the QRS complex
2. Complaints of a "flutter" feeling in the chest
3. Complaints of headache
4. Increased blood glucose level
Correct Answer: 1
Rationale 1: Sotalol delays repolarization and prolongs the refractory period, thus widening the QT interval. Widening of the QRS complex can be a precursor to ventricular tachycardia. The health care provider should be alerted immediately, and the medication held.
Rationale 2: Complaints of a "flutter" feeling in the chest are characteristic of atrial fibrillation, for which the client is receiving treatment.
Rationale 3: There is no indication that treatment with sotalol induces headache as an adverse effect.
Rationale 4: There is no evidence that sotalol increases blood glucose levels.
Global Rationale: Sotalol delays repolarization and prolongs the refractory period, thus widening the QT interval. Widening of the QRS complex can be a precursor to ventricular tachycardia. The health care provider should be alerted immediately, and the medication held. Complaints of a "flutter" feeling in the chest are characteristic of atrial fibrillation, for which the client is receiving treatment. There is no indication that treatment with sotalol induces headache or increased blood glucose levels as an adverse effect.
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