Clostridium Difficile Case Study

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Nursing Management of Patient with Clostridium Difficile

Alyssia R. Twigg

Submitted in partial fulfillment of the requirements for
NURS 342: Nursing Medical Surgical
Shepherd University
Department of Nursing

April 8, 2015
Nursing Management of Patient with Clostridium Difficile
A 55 year old patient was admitted to the inpatient unit from a hospice facility at 4:00 in the afternoon on April 1st, 2015. The patient has end stage pancreatic cancer with liver and bone metastasis. The unit nurse noted foul smelling loose stools upon the patient’s arrival. After 24 hours and three loose stools, a Clostridium toxin assay test was performed and the patient has tested positive for Clostridium difficile toxin (Elsevier, 2015). Today, …show more content…

Often patients encompassing with Clostridium difficile have no symptoms or they may express symptoms of mild diarrhea, pseudomembranous colitis, and inflammation of the colon causing pain (Mitchell, 2014). Clostridium difficile is a bacterial infection of the intestine and it may occur in patients who are immunocompromised or taking broad-spectrum antibiotics. Walter (2014) explains that the most important risk factor for CDI continues to be recent administration of antibiotics. The infection occurs from depression of the normal flora of the bowel through the administration of antibiotics. The depression of the normal flora increases the number of C. difficile bacteria within the intestines. The overgrowth of C. difficile causes diarrhea. Abdominal cramps, fever, and leukocytosis are noted in most patients. Symptoms usually begin 4 to 10 days after the initiation of antibiotic therapy (Elsevier, …show more content…

The SMART goal for the patient’s diagnosis of diarrhea is that the patient will defecate formed, soft stool every 1 to 3 days and will express relief of cramping with little or no diarrhea. The intervention to meet this smart goal is the administration of fidaxomicin, a narrow spectrum antibiotic, to treat the infection of Clostridium difficile (Sears, 2013). Another nursing intervention for the treatment of diarrhea is assessing the patient for sodium and potassium loss, as well as explaining the prevention methods to avoid the spread of excessive diarrhea (Mitchell, 2014). The nurse must also provide proper skin integrity care to the peritoneal are and make the environment safe and easy for access to the bathroom. The SMART goal for the patient’s diagnosis of acute pain is that the patient will state relief of pain in abdominal area after treatment with opioids in a 24hr period. The nursing intervention for acute pain is the administration of opioids as well as positioning to keep patient in as much comfort as possible and take pressure off of the abdominal area. The nurse must also assess the patient’s vital signs and pain level

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