A hospitalized 88-year-old client who has been receiving antibiotics for 10 days tells you that he is having frequent watery stools. Which action will you take first?
A. Obtain stool specimens for culture
B. Place the client on contact precaution
C. Notify the physician about the loose stools
D. Instruct the client about correct handwashing
Correct Answer: B. Place the client on contact precaution
The client’s age, history of antibiotic therapy, and watery stools suggest that he may have Clostridium difficile infection. The initial action should be able to place him on contact precautions to prevent the spread of C. difficile to other clients. Clostridium difficile is a gram-positive bacterium that is the cause most implicated in antibiotic-associated diarrhea. The other actions are also needed and should be taken after placing the client on contact precautions.
Option A: Patients with new-onset 3 or more loose or unformed stools in 24 hours with no obvious other etiology should be checked for testing for C. difficile infection. Stool examination for C. difficile toxins or toxigenic C. difficile bacillus is the commonly used diagnostic test used to diagnose C. difficile infection.
Option C: The management of C. difficile infection includes a multi-step approach of discontinuing the usage of inciting antibiotics, isolating the patient, and administering the antibiotic based on the severity of the infection.
Option D: General strategies such as early detection of the disease, placing the patient under isolation with a dedicated toilet and contact precautions, promoting hygiene measures such as improved hand hygiene, and environmental cleaning are effective measures in preventing infections from C. difficile infections.