The most appropriate statement related to respiratory acidosis is:

IGNOU PB Bsc Nsg.Entrance-2026

Medical & Surgical Nursing

Medium

Appeared in: IGNOU PB Bsc Nsg.Entrance-2026

Explanation

Respiratory acidosis is caused by hypoventilation, where the lungs fail to excrete enough CO₂, leading to its buildup in the blood.
This excess CO₂ increases the level of carbonic acid (H₂CO₃), which lowers the blood pH, making it acidic.
The primary compensatory mechanism for respiratory acidosis is renal (kidney-based).
To restore balance, the kidneys retain bicarbonate (HCO₃⁻), a base, to buffer the excess acid.
Simultaneously, the kidneys increase the excretion of hydrogen ions (H⁺) in the urine to remove acid from the body.

Option A: Respiratory acidosis is caused by an excess of carbonic acid due to CO₂ retention, not a deficiency.
Option C: When the lungs excrete too much carbon dioxide (hyperventilation), it leads to a deficit of carbonic acid, causing respiratory alkalosis, the opposite of acidosis.
Option D: During respiratory acidosis, the kidneys' compensatory response is to increase the excretion of metabolic acids (hydrogen ions) in the urine to help raise the blood pH.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology and compensation of respiratory acidosis as background academic context rather than a clinical decision trigger.
Nurses must monitor patients with conditions like COPD, pneumonia, or those under sedation for signs of respiratory acidosis such as confusion, lethargy, and headache, as it can progress to respiratory failure.
Key nursing interventions focus on improving ventilation. This can include encouraging deep breathing and coughing, administering bronchodilators, or preparing for mechanical ventilation to help the patient eliminate excess CO₂.
What if? If the patient also had chronic kidney disease, their ability to compensate by retaining bicarbonate would be impaired. This would make the respiratory acidosis more severe and difficult to manage, requiring more aggressive respiratory support.

How to Approach the Question

First, identify the core concept from the question stem: 'respiratory acidosis'.
Recall the basic definition: 'Respiratory' points to the lungs and CO₂, while 'acidosis' means the blood is too acidic (low pH).
Connect the cause and effect: Respiratory acidosis is caused by the lungs retaining too much CO₂ (hypoventilation), which increases carbonic acid.
Think about how the body compensates. The opposite system tries to fix the problem. For a respiratory issue, the metabolic system (kidneys) will compensate.
To fight acidosis, the kidneys must do two things: get rid of acid (excrete H⁺) and hold onto a base (retain HCO₃⁻).
Evaluate each option based on this logic. Option B, 'Kidneys retain more bicarbonate than usual', directly matches the correct compensatory mechanism.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 55-57

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