A nurse is reviewing the laboratory results of a client who was an unrestrained passenger in a motor-vehicle crash. The ABG results are as follows: pH 7.32, HCO3 24 mEq/L, PaCO2 48 mm Hg. The nurse should identify the client is experiencing which of the following acid-base imbalances?

A) Drink 8 oz of milk when hypoglycemia develops:
While consuming a fast-acting carbohydrate is important during hypoglycemia, 8 oz of milk may not be the most effective choice. Typically, glucose tablets or juice are recommended as they provide a quicker absorption of sugar into the bloodstream.

B) Initiate a 1,400-calorie diet daily:
Caloric needs should be individualized based on the adolescent’s age, weight, activity level, and overall health. A fixed 1,400-calorie diet might not be appropriate for every adolescent and could lead to insufficient energy intake or excessive restriction.

C) Rotate the insulin injection site to a different area of the body with every other injection:
While rotating injection sites is important to prevent lipodystrophy, it is generally recommended to use different sites within the same area (such as different spots on the abdomen) rather than entirely different areas of the body with each injection. This ensures consistent absorption of insulin.

D) Keep unopened insulin refrigerated at 4.44° C (40° F):
Unopened insulin should be stored in the refrigerator to maintain its potency until it is ready to be used. This temperature range ensures the insulin remains stable and effective for use.

A) Potatoes: Potatoes are not particularly high in oxalates and can be included in the diet for individuals who have had calcium oxalate renal calculi. They do not significantly contribute to oxalate levels and are generally considered safe for those managing this type of kidney stone.

B) Mushrooms: While mushrooms are a nutritious food, they do not have a high oxalate content compared to other foods. Therefore, they are not a primary concern for individuals managing calcium oxalate stones.

C) Eggs: Eggs are low in oxalates and do not contribute significantly to the formation of calcium oxalate renal stones. They are a good source of protein and can be included in the diet.

D) Spinach: Spinach is high in oxalates and should be limited in the diet of individuals who have experienced calcium oxalate renal calculi. High oxalate foods can contribute to the formation of calcium oxalate stones, so limiting spinach can help reduce the risk of recurrence.