The nursing instructor is discussing renal failure with her senior nursing class. The instructor states, "A patient in renal failure partially loses the ability to regulate changes in pH." What is the cause of this partial inability?
A) The kidneys regulate and reabsorb carbonic acid to change and maintain pH.
B) The kidneys buffer acids through electrolyte changes.
C) The kidneys regenerate and reabsorb bicarbonate to maintain a stable pH.
D) The kidneys combine carbonic acid and bicarbonate to maintain a stable pH.
Ans: C
Feedback: The kidneys regulate the bicarbonate level in the ECF; they can regenerate bicarbonate ions as well as reabsorb them from the renal tubular cells. In respiratory acidosis and most cases of metabolic acidosis, the kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. Option A is incorrect; the lungs regulate and reabsorb carbonic acid to change and maintain pH. Option B is incorrect; the kidneys do not buffer acids through electrolyte changes; buffering occurs in reaction to changes in pH. Option D is incorrect; carbonic acid works as the chemical medium to exchange O2 and CO2 in the lungs to maintain a stable pH while the kidneys use bicarbonate as the chemical medium to maintain a stable pH by moving and eliminating H+.
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