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. "When I went to the restroom the last few days, my urine smelled odd."
Changes in the smell of urine can be associated with various conditions, including diabetes. However, it's not a specific symptom.

B. "I've always been a fan of sweet foods, but lately I'm turned off by them."
A change in taste preferences may not be directly related to diabetes. It's not a typical symptom.

C. "No matter how much sleep I get, it seems to take me hours to wake up."
Fatigue and difficulty waking up are general symptoms that can be caused by various factors, including diabetes. However, it's not specific to diabetes alone.

D. "Lately, I drink a lot, but I can't seem to quench my thirst."
Excessive thirst (polydipsia) and increased urination (polyuria) are classic symptoms of diabetes, suggesting elevated blood sugar levels.

A. I will report nausea, vomiting, or diarrhea to my primary care provider.
Correct Understanding: This is correct. Reporting these symptoms is essential because illness, especially with symptoms like nausea, vomiting, or diarrhea, can impact blood glucose levels.

B. I should avoid carbohydrates when I'm sick.
Need for Further Teaching: During illness, it's important to continue consuming carbohydrates. However, the type and amount of carbohydrates might need to be adjusted. Patients should consult their healthcare providers for guidance on managing carbohydrate intake during illness.

C. I should stop taking my insulin or oral antidiabetic agents.
Need for Further Teaching: It is not advisable to stop insulin or oral antidiabetic agents during illness. In fact, these medications often need to be continued, with potential adjustments made under the guidance of healthcare providers.

D. I will test my blood glucose and test urine ketones every 3 to 4 hours.
Correct Understanding: This is correct. Regular monitoring of blood glucose and urine ketones during illness is crucial for managing diabetes and detecting any potential complications.

E. I will continue taking my insulin or oral antidiabetic agents as usual.
Correct Understanding: This is correct. It's important to continue taking insulin or oral antidiabetic agents during illness to help manage blood glucose levels.