A client in the emergency department reports that he has been vomiting excessively for the last 2 days. His arterial blood gas (ABG) analysis shows a pH of 7.50, the partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance?

A. Increase the intake of vitamin E to enhance absorption:
While vitamin C can enhance iron absorption, vitamin E does not play a significant role in iron absorption. Vitamin C-rich foods can be advised to enhance iron absorption.

B. Iron will cause the stools to darken in color:
This statement is accurate. Iron supplements can cause stools to appear darker in color, often black or greenish-black. This change in stool color is normal and expected when taking iron supplements.

C. Take the iron with dairy products to enhance absorption:
Dairy products can inhibit iron absorption. It's better to take iron supplements with vitamin C-rich foods or orange juice to enhance absorption.

D. Limit foods high in fiber due to the risk for diarrhea:
Fiber-rich foods do not necessarily need to be limited when taking iron supplements. However, some individuals may experience constipation when taking iron supplements, in which case increasing fluid intake and dietary fiber can help alleviate constipation.

A. Inform the primary care provider that the patient may have an infection:
Explanation: The presence of an elevated oral temperature and new onset of fine crackles on lung auscultation suggests a potential respiratory infection, which is a significant concern in a patient with sickle cell disease. Notifying the primary care provider allows for further evaluation and appropriate management of the infection.

B. Liaise with the respiratory therapist and consider high-flow oxygen:
Explanation: While oxygenation may be necessary, especially if the patient is experiencing respiratory distress, addressing the potential infection is the priority. Consulting with the respiratory therapist and considering high-flow oxygen can be part of the overall plan based on the primary care provider's recommendations.

C. Apply supplementary oxygen by nasal cannula:
Explanation: Providing oxygen support may be necessary, but it should be done in consultation with the primary care provider, who can guide the appropriate level of oxygen therapy based on the patient's condition.

D. Administer bronchodilators by nebulizer:
Explanation: Bronchodilators are typically used for conditions like asthma or COPD, and their use might not be the primary intervention in the context of a sickle cell crisis with signs of a potential respiratory infection. Addressing the infection takes precedence, and the primary care provider's input is essential in determining the appropriate course of action.