The body’s compensation of metabolic alkalosis involves:
A. Increasing the respiratory rate
B. Decreasing the respiratory rate
C. Increasing urine output
D. Decreasing urine output
Correct Answer: B. Decreasing the respiratory rate
The body attempts to compensate for metabolic alkalosis by decreasing the respiratory rate and conserving carbon dioxide (an acid). The body compensates for both alkalosis and acidosis mainly through the lungs. The lungs change the alkalinity of the blood by allowing more or less carbon dioxide to escape as the client breathes. The kidneys also play a role by controlling the elimination of bicarbonate ions.
Option A: In metabolic acidosis, as blood pH drops (becomes more acidic), the parts of the brain that regulate breathing are stimulated to produce faster and deeper breathing (respiratory compensation). Breathing faster and deeper increases the amount of carbon dioxide exhaled. The kidneys also try to compensate by excreting more acid in the urine.
Option C: Urine volume does not influence acid-base balance. The kidneys compensate for a respiratory acidosis by tubular cells reabsorbing more HCO3 from the tubular fluid, collecting duct cells secreting more H+ and generating more HCO3, and ammoniagenesis leading to increased formation of the NH3 buffer.
Option D: The kidney compensates in response to respiratory alkalosis by reducing the amount of new HCO3? generated and by excreting HCO3?. The process of renal compensation occurs within 24 to 48 hours. The stimulus for the renal compensatory mechanism is not pH, but rather Pco2.
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