Acid-Base Compensation

Question 1

Compensation works on the balance between what?

Answer 1

the lungs (CO2) & the kidneys (HCO3)

Question 2

what compensation occurs for respiratory acidosis?

Answer 2

Kidneys reabsorb HCO3- and excrete H+

Question 3

what compensation occurs for respiratory alkalosis?

Answer 3

The body pulls HCO3- into the blood which converts to carbonic acid which lowers the pH

Question 4

what happens if sx of respiratory alkalosis continue for over 6 hrs?

Answer 4

1) the kidneys increase excretion of HCO3
2) reduce the excretion of H+ (remember the more H+ we have, the lower the pH)
3) pH begins to fall

Question 5

what do we initially see in metabolic acidosis?

Answer 5

respiratory compensation
Will see immediate respiratory changes → Kussmaul breathing

Question 6

List the compensation method for each imbalance

Answer 6

Respiratory Acidosis
- metabolic compensation
- HCO3 retained by kidneys

Respiratory Alkalosis
- metabolic compensation
- HCO3 excreted by the kidneys

Metabolic Acidosis
- respiratory compensation
- CO2 blown off by the lungs

Metabolic Alkalosis
- respiratory compensation
- CO2 retained by the lungs

Question 7

difference between kidney vs lung compensation

Answer 7

kidneys take a couple days to kick in and compensate but lasts longer

the lungs kick in immediately but is only temporary

Question 8

in respiratory acidosis, why does the body retain HCO3?

Answer 8

the kidneys want to retain bicarbonate to bring the pH up

Question 9

in respiratory alkalosis, why does the body excrete HCO3?

Answer 9

the kidneys want to excrete bicarbonate to bring the pH down

Question 10

why do we see kussmauls in metabolic acidosis?

Answer 10

blowing off CO2 brings the pH up

Question 11

what does this represent: pH 7.32, PaCO2 56, HCO3 28

Answer 11

Partially compensated respiratory acidosis

Cannot be metabolic because the pH and Bicarb are opposite & must be the SAME!!! → this is how we know it is respiratory**