Which of the following information best helps to distinguish chronic hypercapnic respiratory failure from acute hypercapnic respiratory failure?
a. Long-standing dyspnea that worsens on exertion
b. Forced expiratory volume in 1 sec to forced vital capacity ratio (FEV1/FVC) of less than 75% predicted
c. Kidneys retaining bicarbonate to elevate the blood pH
d. Physical signs of hypoxemia, such as cya-nosis and clubbing
ANS: C
Most commonly, chronic hypercapnic respiratory failure accompanying COPD or obesi-ty-hypoventilation syndrome would elicit a renal response by which the kidneys retain bicar-bonate to elevate the blood pH.
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