Medical Surgical EKG #15

Question

The nurse places the client on a monitor and interprets the findings after analyzing the following electrocardiogram (ECG):


Based on the nurse’s interpretation, the ECG monitor reveals:

Answers

  1. Premature ventricular contractions (PVCs)
    • Rationale:

      This answer is correct because the rhythm shown in the ECG strip is sinus rhythm with a distinct P wave that initiates a normal QRS followed by a premature QRS complex that is wider and results from increased irritability within the ventricles. They may be unifocal or may occur in frequent patterns. Potassium levels should be evaluated since hypokalemia may cause PVCs. The person with a PVC feels as though their heart skipped a beat.

  2. Ventricular tachycardia
    • Rationale:

      This answer is not correct because ventricular tachycardia is an unusually fast heartbeat. It is defined as at least 3 or more heart beats of more than 100 bpm that originates from the ventricles. If VT lasts more than a couple of seconds at a time, it can be life-threatening. The rhythm shown on the ECG strip is sinus rhythm with a PVC.

  3. Sick sinus syndrome
    • Rationale:

      This answer is not correct because sick sinus syndrome (also known as sinus node dysfunction) is when the heart’s pacemaker (the SA node) does not produce a heart rate that meets the body’s perfusion needs. Arrhythmias can also occur. The rhythm shown on the ECG strip is sinus rhythm with a PVC.

  4. Paroxysmal atrial tachycardia
    • Rationale:

      This answer is not correct because paroxysmal atrial tachycardia, a form of supraventricular tachycardia, is an atrial tachyarrhythmia that occurs in random episodes. The rhythm shown on the ECG strip is sinus rhythm with a PVC.

Overview

Premature ventricular contractions (PVCs) are abnormal, additional heartbeats that disrupt the regular heart rhythm.

Explanation

Learning Outcomes

Premature ventricular contractions (PVCs) are abnormal, additional heartbeats that disrupt the regular heart rhythm. The abnormal heartbeat begins in the ventricle and causes a contraction to occur prematurely, which is reflected in a widened QRS complex. The rhythm shown in the ECG strip is sinus rhythm with a distinct P wave that initiates a normal QRS followed by a premature QRS complex that is wider and results from increased irritability within the ventricles. They may be unifocal or may occur in frequent patterns. Potassium levels should be evaluated since hypokalemia may cause PVCs. The person with a PVC feels as though their heart skipped a beat.

Test Taking Tip

Even though an occasional PVC is not generally concerning, lifestyle changes can help decrease or eliminate their occurrence. Decreasing stress and caffeine are a couple changes which can significantly decrease PVCs.

Video Rationale