A nurse is reviewing laboratory results of a client. The client's ABG results are as follows: pH 7.2, HCO, 26 mEq/L, PaCO2 52 mm Hg. Which of the following acid-base imbalances should the nurse identify the client is experiencing?

A) "I should make sure that most of my meals contain fried foods to maintain my calorie count": Fried foods are generally high in fat and can be difficult to digest, particularly for individuals with malabsorption syndrome. They are not recommended as a primary source of calories due to their potential to exacerbate gastrointestinal symptoms.

B) "I should change to a gluten-free diet to rest my bowel": A gluten-free diet is beneficial for individuals with celiac disease, but it is not universally required for all inflammatory bowel diseases. The decision to adopt a gluten-free diet should be based on specific medical advice rather than general guidelines for inflammatory bowel disease.

C) "I should try to limit foods containing lactose to prevent bloating and cramping": Limiting lactose-containing foods is a common recommendation for individuals with malabsorption syndrome, especially if lactose intolerance is present. Lactose can exacerbate bloating and cramping, so managing intake can help alleviate these symptoms.

D) "I should eat a high-fiber diet daily to decrease my episodes of flare-ups": High-fiber diets are not always recommended for individuals with inflammatory bowel disease, as fiber can exacerbate symptoms and contribute to flare-ups. A low-fiber or modified fiber diet may be more appropriate depending on the individual’s symptoms and disease state.

A) "Limit sodium intake to 3,500 milligrams per day.":
Limiting sodium intake is crucial for managing heart failure to prevent fluid retention and exacerbation of symptoms. However, the recommended limit is typically much lower, around 1,500 to 2,000 milligrams per day, not 3,500 milligrams.

B) "Take ibuprofen for discomfort.":
Ibuprofen and other NSAIDs are not recommended for clients with heart failure as they can cause fluid retention, worsen heart failure symptoms, and increase the risk of kidney problems. Alternatives such as acetaminophen are generally safer for pain relief.

C) "Increase the distance you walk by 100 feet daily, even if you feel fatigued.":
While regular exercise is important, clients with heart failure should not push through fatigue, as overexertion can lead to worsening symptoms. Exercise recommendations should be tailored to the individual's tolerance and should be adjusted based on their energy levels.

D) "Include no more than 2,000 milliliters of fluid intake in 24 hours.":
Restricting fluid intake to 2,000 milliliters per day helps prevent fluid overload, which is critical for managing heart failure. Monitoring and limiting fluid intake can help control symptoms such as edema and shortness of breath.