A. Indicate the normal ranges of the vital sign (for children and adult) listed below.

1. Heart rate/Pulse rate

Children: 70 – 120 beats per minute
Adult: 60 – 100 beats per minute
2. Blood Pressure
Children: 60/40
Adult: 120/80
3. Respiratory Rate
Children: 12 – 20 breaths per minute
Adult: 12 – 16 breaths per minute
B. List the common palpable sites for pulse taking
1. Radial Artery Pulse – taken at the radial artery; traditionally used because it is
the most easily accessible artery in the body
2. Carotid Artery Pulse – below the jaw line between the trachea and
sternocleidomastoid; most commonly used during CPR in an adult; it will
lessen if there is syncope
3. Temporal Pulse – located at the temple directly in front of the ear
4. Brachial Artery Pulse – used to measure blood pressure; pulse check site on an
infant during CPR
5. Ulnar Pulse – weaker than the radial pulse
6. Apical Pulse – point of maximal impulse; found at the apex of the heart, on the
left side of the chest at the 5th intercostal space midclavicular line
7. Femoral Pulse – deeply in the groin below the inguinal ligament between the
pubic symphisis and anterior superior iliac spine
8. Popliteal artery – found behind the knee and comes off of the femoral artery.
9. Posterior tibial artery – found on the inside of the ankle between the bony part
of the ankle bone and Achilles tendon; particularly assessed in patients with
peripheral vascular disease
10. Dorsalis pedis artery – lateral to the extensor hallucis longus tendon on the
dorsal surface of the foot
C. Electrocardiography
1. Define its purpose.
Electrocardiography is a record of the electrical activity of the heart. It is a
medical test significant in diagnosing a number of abnormal cardiac rhythms
and other abnormalities. ECG analysis can also reveal abnormal conduction
pathways, hypertrophy or atrophy of portions of the heart, and the
approximate location of damaged cardiac muscle.
2. Explain each ECG waves; P waves, QRS complex, ST segment, T wave.
P wave is the first of the three recognizable waves of a typical ECG. It is small
and is the result of the action potentials. It causes the depolarization of the
atrial myocardium which signals the onset of atrial contraction. QRS complex
on the other hand has a complicated shape and is the result of the ventricular
depolarization. Thus, it signals the onset of ventricular contraction. The
interval between ventricular depolarization and ventricular repolarization is
 the ST segment. It is often characterized as the flat section at the end of the
QRS complex to the beginning of the T wave. T wave is the result from currents
flowing during the repolarization of the ventricles. It represents ventricle
repolarization and precedes ventricular relaxation.
D. Describe the following terms:
1. Hypotension – low blood pressure
2. Hypertension – high blood pressure
3. Tachycardia – an abnormal, rapid heart rate, over 100 beats per minute
4. Bradycardia – slow heart rate, usually defined as a rate under 60 beats per
minute
5. Eupnea – normal breathing
6. Tachypnea – breathing faster than normal; rapid breathing
7. Bradypnea – breathing slower than normal
8. Hyperpnea – deep breathing; breathing more air but not necessarily breathing
faster
9. Apnea – slowed or stopped breathing
10. Dyspnea – difficult breathing; shortness of breath
11. Epistaxis – nose bleeding
12. Hypoventilation – shallow or slow breathing; carbon dioxide rises
13. Hyperventilation – deep and rapid breathing; carbon dioxide is low
14. Hypercapnea – too much carbon dioxide in the blood stream
15. Hypocapnea – blood carbon dioxide levels are below normal
16. Hypoxia – inadequate oxygen in tissues
17. Hypoxemia – inadequate oxygen in the blood
18. Cyanosis – bluish discoloration of the skin due to lack of oxygen in the blood
E. Compare the following and give examples for each.
1. Respiratory Acidosis – Respiratory Alkalosis
Respiratory Acidosis
 Too much carbon dioxide in the body
 Caused by inadequate ventilation because CO2 is retained in the body.
Consequently, increase concentration of carbon dioxide reacts with
water forming H2CO3. Carbonic acid forms hydrogen ions and
bicarbonate. The increase in hydrogen ion concentration causes the pH
of the body fluids to decrease.
Example: Hypoventilation (e.g., impaired respiratory center function due
to trauma, tumor, shock, or renal failure), carbon dioxide is not eliminated
thus, it eventually rises causing a decrease in pH
Respiratory Alkalosis

 Reduced carbon dioxide levels in the extracellular fluid

 Results from hyperventilation which eliminates too much carbon
dioxide from the body. Decreased concentration of carbon dioxide
causes hydrogen ions to react with bicarbonate to form carbonic acid.
 The H2CO3 forms H20 and CO2. The resulting decrease in the
concentration of hydrogen ions which causes the pH of the body fluids
to increase.
Example: Hyperventilation (e.g., due to emotions) will cause the reduction
of carbon dioxide in the body which will eventually result to an increase of
the pH
2. Metabolic Acidosis – Metabolic Alkalosis
Metabolic Acidosis
 Too much acid is produced in the body
 Results from all conditions that decrease the pH of the body fluids
below 7.35 except for certain respiratory system conditions
Example: Diabetic acidosis which develops when substances called ketone
bodies (which are acidic) build up during uncontrolled diabetes

Metabolic Alkalosis
 Result of decreased hydrogen ion concentration which often leads to
the increase of bicarbonate
 Results from all conditions that increase the pH of the body fluids above
7.45 with the exception of those resulting from altered function of the
respiratory system
Example: Severe vomiting causes elimination of hydrogen ions and
reabsorption of bicarbonate in the stomach or kidneys
3. Compensated and Uncompensated Respiratory Acidosis
Compensated Respiratory Acidosis
 When the pH is imbalanced within the normal range but concentration
of CO2 and HCO3 are increased
Example:
pH = 7. 37
PaCO2 = 52 mmHg
HCO3 = 35 mmol/L
Uncompensated Respiratory Acidosis
 When the pH is below the normal range, CO2 is increased but HCO3 is
normal
Example:
pH = 7.16
PaCO2 = 65 mmHg
HCO3 = 24 mmol/L
4. Compensated and Uncompensated Respiratory Alkalosis
Compensated Respiratory Alkalosis
 When the pH is within the normal range but a decrease in CO2 and
HCO3
Example:
pH = 7.42
PaCO2 = 30 mmHg
HCO3 = 19 mmol/L
Uncompensated Respiratory Alkalosis
 When the pH is above normal, CO2 is below normal, but HCO3 is within
the normal range
Example:
pH = 7.44

PaCO2 = 33 mmHg
HCO3 = 25 mmol/L
5. Compensated and Uncompensated Metabolic Acidosis
Compensated Metabolic Acidosis
 When the pH is within the normal range but CO2 and HCO3 are below
the normal concentration
Example:
pH =7.35
PaCO2 =29 mmHg
HCO3 = 21 mmol/L
Uncompensated Metabolic Acidosis
 When the pH is below normal as well as the bicarbonate but CO2 is
within its normal range
Example:
pH = 7.22
PaCO2 = 41 mmHg
HCO3 = 17 mmol/L

6. Compensated and Uncompensated Metabolic Alkalosis

 Compensated Metabolic Alkalosis
 When the pH is imbalanced within the normal range but CO2 and HCO3
are increased above normal
Example:
pH = 7.43
PaCO2 = 55 mmHg
HCO3 = 31 mmol/L
Uncompensated Metabolic Alkalosis
 When pH and HCO3 are above the normal range but CO2 is normal
Example:
pH = 7.48
PaCO2 = 39 mmHg
HCO3 = 33 mmol/L
F. Normal ranges of the following
1. pH
 7.35 -7.45
2. pHCO3
 22 – 26 mmol/L
3. pCO2
 35 -45 mmHg
4. pO2
 80 – 100 mmHg

G. Analyze the following

1. Uncompensated Metabolic Alkalosis
2. Uncompensated Respiratory Acidosis