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Zorluk: KolayPhysiological Adaptation

A nurse is reviewing the arterial blood gas (ABG) results for a client with a long history of severe chronic obstructive pulmonary disease (COPD). Which of the following ABG findings indicates that the client's body has physiologically compensated for the chronic respiratory condition?

  1. An elevated bicarbonate (HCO3-) levelCevap
  2. B
    A decreased bicarbonate (HCO3-) level
  3. C
    A decreased partial pressure of carbon dioxide (PaCO2)
  4. D
    An elevated partial pressure of oxygen (PaO2)

Cevap

An elevated bicarbonate (HCO3-) level
In clients with severe COPD, chronic retention of carbon dioxide leads to respiratory acidosis. Over time, the body physiologically adapts to this state through renal compensation. The kidneys retain and increase the production of bicarbonate (a base) to buffer the excess acid and maintain the blood pH as close to the normal range as possible.

Adım Adım Çözüm

1
Identify the primary acid-base imbalance associated with COPD.
COPD causes chronic airflow limitation, leading to the retention of carbon dioxide (CO2), which creates a state of chronic respiratory acidosis.
Understanding the underlying pathophysiology is necessary to anticipate the body's compensatory mechanisms.
2
Determine the body's physiological compensatory mechanism for respiratory acidosis.
The kidneys respond to elevated CO2 levels by retaining and producing more bicarbonate (HCO3-) to buffer the acid and raise the blood pH back toward normal.
Renal compensation is the primary way the body adapts to chronic respiratory acid-base imbalances.

Anahtar Kavram

Renal compensation in chronic respiratory acidosis
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