When caring for a patient with end-stage COPD, the nurse recognizes compensation for the acid?base abnormality is present when which of the following occurs?
1. The kidney retains bicarbonate in excess of normal.
2. The pCO2 is less than 35 mm Hg.
3. The oxygenation improves.
4. Hypoventilation occurs with a pCO2 greater than 45 mm HG.
The kidney retains bicarbonate in excess of normal.
Rationale: The client with COPD cannot efficiently eliminate CO2, resulting in respiratory acidosis, manifested by a pCO2 greater than 45 mm HG. To compensate for this, bicarbonate is retained by the kidney. Oxygenation is typically poor in the client with COPD. While clients with COPD hypoventilate, this is a manifestation of the underlying disorder, not the compensation.
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