The nurse is caring for a patient at risk for premature ventricular contractions (PVCs). While monitoring the patient's EKG rhythm, the nurse should look for:

Wide QRS complexes in the absence of P waves.


• PVCs are wide, bizarre QRS complexes in the absence of P waves, usually followed by a fully-compensated pause

• PVCs may increase with anxiety, stress, use of alcohol, stimulant medication, hypoxia, or electrolyte abnormalities

• PVCs are caused by abnormal automaticity of ventricular cells and are very common. They may occur erratically or at regular intervals. Trigeminy is every third beat, bigeminy is every second beat

• Narrow QRS complexes do not represent PVCs, the QRS complex is instead wide

• PVCs occur without a P wave before them as the ventricles contract before the atria

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