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. Management of diabetic ketoacidosis:
Diabetic ketoacidosis (DKA) is a severe complication of diabetes characterized by high blood sugar, ketones in the urine, and metabolic acidosis. While it's crucial to understand how to manage DKA, this may be considered more advanced knowledge and may not be categorized as a basic survival skill for someone newly diagnosed with type 1 diabetes.

B. Signs and symptoms of diabetic neuropathy:
Diabetic neuropathy is a long-term complication that involves damage to the nerves due to prolonged high blood sugar levels. While understanding neuropathy is important for long-term health, it may not be the first topic addressed as a basic survival skill for someone newly diagnosed.

C. Effects of surgery and pregnancy on blood sugar levels:
Understanding how surgery and pregnancy can affect blood sugar levels is important for managing diabetes in specific situations. However, this knowledge might be considered more advanced and may not be the initial focus for someone just starting to learn about diabetes self-care.

D. Recognition of hypoglycemia and hyperglycemia:
Recognizing the signs and symptoms of both low and high blood sugar is essential for immediate self-care. This includes understanding when blood sugar is too low (hypoglycemia) and requires prompt treatment, as well as recognizing the symptoms of high blood sugar (hyperglycemia) and knowing how to address them. This knowledge is fundamental for the daily management and well-being of someone with diabetes.

A. 15 to 20 g of a fast-acting carbohydrate such as orange juice:
This is a standard and initial treatment for hypoglycemia. Fast-acting carbohydrates, like orange juice or glucose tablets, can quickly raise blood sugar levels. However, in the scenario described, the client is still conscious, and glucagon may be a more appropriate choice.

B. I.V. bolus of dextrose 50%:
Intravenous (IV) dextrose is a more aggressive intervention and is typically reserved for severe cases of hypoglycemia or for unconscious patients. It is not the first-line treatment for conscious patients.

C. I.M. or subcutaneous glucagon:
Glucagon is a hormone that raises blood sugar levels by promoting the conversion of stored glycogen in the liver to glucose. It is administered either intramuscularly (I.M.) or subcutaneously. In a conscious patient with hypoglycemia who cannot take oral carbohydrates, glucagon can be an effective and rapid way to raise blood sugar levels.

D. 10 U of fast-acting insulin:
Administering more insulin in a situation of hypoglycemia would worsen the condition. The goal in hypoglycemia is to raise blood sugar, and giving more insulin would have the opposite effect.