A client with renal impairment presents with an acid-base imbalance. Which mechanisms does the nurse recognize may be impaired? Select all that apply.
A) Resorption of bicarbonate from the renal tubule into the blood.
B) Secretion of bicarbonate into the urine.
C) Resorption of hydrogen from the nephron into the blood.
D) Excretion of hydrogen buffered by ammonia.
E) Secretion of hydrogen into the urine.
A) Resorption of bicarbonate from the renal tubule into the blood.
D) Excretion of hydrogen buffered by ammonia.
E) Secretion of hydrogen into the urine.
Explanation: A) The kidneys contribute to acid-base balance by three mechanisms that take place along the tubules of the nephron: resorption of bicarbonate from the renal tubule into the blood, excretion of hydrogen buffered by ammonia, and secretion of hydrogen into the urine. Impairment of the kidneys may impair one or all of these processes. Impairment of the kidneys may lead to impaired secretion of hydrogen into the urine, not bicarbonate.
B) The kidneys contribute to acid-base balance by three mechanisms that take place along the tubules of the nephron: resorption of bicarbonate from the renal tubule into the blood, excretion of hydrogen buffered by ammonia, and secretion of hydrogen into the urine. Impairment of the kidneys may impair one or all of these processes. Impairment of the kidneys may lead to impaired secretion of hydrogen into the urine, not bicarbonate.
C) The kidneys contribute to acid-base balance by three mechanisms that take place along the tubules of the nephron: resorption of bicarbonate from the renal tubule into the blood, excretion of hydrogen buffered by ammonia, and secretion of hydrogen into the urine. Impairment of the kidneys may impair one or all of these processes. Impairment of the kidneys may lead to impaired secretion of hydrogen into the urine, not bicarbonate.
D) The kidneys contribute to acid-base balance by three mechanisms that take place along the tubules of the nephron: resorption of bicarbonate from the renal tubule into the blood, excretion of hydrogen buffered by ammonia, and secretion of hydrogen into the urine. Impairment of the kidneys may impair one or all of these processes. Impairment of the kidneys may lead to impaired secretion of hydrogen into the urine, not bicarbonate.
E) The kidneys contribute to acid-base balance by three mechanisms that take place along the tubules of the nephron: resorption of bicarbonate from the renal tubule into the blood, excretion of hydrogen buffered by ammonia, and secretion of hydrogen into the urine. Impairment of the kidneys may impair one or all of these processes. Impairment of the kidneys may lead to impaired secretion of hydrogen into the urine, not bicarbonate.
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