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Which of these clients would the nurse monitor for the complication of C. difficile diarrhea?
1. An adolescent taking medications for acne
2. An elderly client living in a retirement center taking prednisone
3. A young adult at home taking a prescribed aminoglycoside
4. A hospitalized middle aged client receiving clindamycin
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Answer
You chose number: 4
The correct answer is number: 4
You are correct!
Hospitalized patients, especially those receiving antibiotic therapy, are primary targets for C. difficile. Of patients receiving antibiotics, 5-38% experience antibiotic-associated diarrhea; C. difficile causes 15 to 20% of the cases. Several antibiotic agents have been associated with C. difficile. Broad-spectrum agents, such as clindamycin, ampicillin, amoxicillin, and cephalosporins, are the most frequent sources of C. difficile. Also, C. difficile infection has been caused by the administration of agents containing beta-lactamase inhibitors (ie, clavulanic acid, sulbactam, tazobactam) and intravenous agents that achieve substantial colonic intraluminal concentrations (ie, ceftriaxone, nafcillin, oxacillin). Fluoroquinolones, aminoglycosides, vancomycin, and trimethoprim are seldom associated with C. difficile infection or pseudomembranous colitis.
Smeltzer, S.C. and Bare, B.G.(2004)
Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.
Swearingen, P.
All-in-One Care Planning Resource: Medical-surgical, Pediatric, Maternity, and Psychiatric Nursing Care Plans.St. Louis: Mosby.
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