This discussion topic is regarding acid-base homeostasis and has two parts. 

Part 1: The link below is for Oregon State University’s open source textbook for their Anatomy & Physiology course. Please read this section (26.4: Acid-Base Balance). This is a supplement to the discussions in Chapters 13 & 14. 

The key here is that you have two systems now working together to address situations where acid/base homeostasis is disturbed.  

https://open.oregonstate.education/aandp/chapter/26-4-acid-base-balance/#:~:text=Buffer%20Systems%20in%20the%20Body&text=The%20respiratory%20tract%20can%20adjust,days%20to%20have%20an%20effect. (Links to an external site.)

Part 2: Clinical Case Study – Diabetic ketoacidosis 

Read the case summary below and then answer the questions that follow.

Case: During your shift in the ER, a 21-year old noncompliant male with a history of type I (insulin-dependent) diabetes mellitus was found in a coma.

Labs revealed the following: his blood glucose was high, as well as his urine glucose, urine ketones, and serum ketones. His serum bicarbonate was <12 mEq/L. His respiration was exaggerated and his breath had an acetone odor. His blood pressure was 90/60 and his pulse weak and rapid (120).

Based on your understanding of both the respiratory and renal regulation of blood pH, answer the following:

1. Is this patient experiencing respiratory or metabolic acidosis? Why?

2. How does the following formula represent the respiratory & renal systems’ regulation of acid-base balance:

CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3–