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. The need to monitor urine for the presence of albumin:
Explanation: Monitoring urine for albumin is more associated with microvascular complications, particularly diabetic nephropathy. When the kidneys are affected, albumin may leak into the urine. This is not a macrovascular complication.

B. The relationship between kidney function and blood glucose levels:
Explanation: The relationship between kidney function and blood glucose levels is important, but it is more directly related to microvascular complications, particularly diabetic nephropathy. High blood glucose levels over time can damage the small blood vessels in the kidneys.

C. The need for frequent eye examinations for clients with diabetes:
Explanation: This is related to microvascular complications, specifically diabetic retinopathy. Changes in the small blood vessels of the retina can lead to vision problems. While important, it's not directly addressing macrovascular complications.

D. The fact that clients with diabetes have an elevated risk of myocardial infarction:
Explanation: This is the correct answer. Macrovascular complications involve large blood vessels and are associated with conditions such as coronary artery disease, which increases the risk of myocardial infarction in individuals 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.