During chemotherapy for lymphocytic leukemia, Mathew develops abdominal pain, fever, and “horse barn” smelling diarrhea. It would be most important for the nurse to advise the physician to order:
A. Enzyme-linked immunosuppressant assay (ELISA) test.
B. Electrolyte panel and hemogram.
C. Stool for Clostridium difficile test.
D. Flat plate X-ray of the abdomen.
Correct Answer: C. Stool for Clostridium difficile test.
Immunosuppressed clients — for example, clients receiving chemotherapy, — are at risk for infection with C. difficile, which causes “horse barn” smelling diarrhea. Successful treatment begins with an accurate diagnosis, which includes a stool test.
Option A: The ELISA test is diagnostic for human immunodeficiency virus (HIV) and isn’t indicated in this case.
Option B: An electrolyte panel and hemogram may be useful in the overall evaluation of a client but aren’t diagnostic for specific causes of diarrhea.
Option D: A flat plate of the abdomen may provide useful information about bowel function but isn’t indicated in the case of “horse barn” smelling diarrhea.