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Difficulty: MediumStandard and Transmission-Based Precautions

An adult client on a medical-surgical unit reports severe abdominal cramping and multiple episodes of watery stool. Laboratory results confirm a *Clostridioides difficile* infection. Which interventions are appropriate for managing this client's care environment? Select all that apply.

  1. Don a disposable gown and gloves before crossing the threshold into the client's room.Answer
  2. B
    Remove the soiled gown and gloves in the hallway immediately after closing the client's door.
  3. Dedicate a stethoscope, blood pressure cuff, and thermometer specifically for this client's use.Answer
  4. D
    Assign the unlicensed assistive personnel (UAP) to evaluate the client's skin turgor for signs of dehydration.
  5. Perform hand hygiene meticulously with soap and water after completing client care.Answer
  6. F
    Post a visible alert on the room door stating the client's specific infectious diagnosis.

Answer

The appropriate interventions are to don a disposable gown and gloves before entering the room, dedicate reusable medical equipment exclusively for this client, and perform hand hygiene using soap and water.
*Clostridioides difficile* is an enteric pathogen that causes severe diarrhea and requires strict Contact Precautions. To prevent cross-contamination, healthcare workers must don a gown and gloves prior to entering the client's room. Additionally, any reusable medical equipment should remain dedicated strictly to that client's use. Because *C. difficile* forms highly resilient spores that are not destroyed by alcohol-based hand sanitizers, healthcare personnel must perform hand hygiene with soap and water to physically wash the spores off the hands and down the drain.

Step-by-Step Solution

1
Identify the required isolation precautions based on the pathogen.
Clostridioides difficile requires strict Contact Precautions.
The pathogen is transmitted via the fecal-oral route and spores can heavily contaminate the client's environment.
2
Determine the correct protocol for Personal Protective Equipment (PPE) and environmental controls.
Gowns and gloves must be worn upon entry and removed before exiting the room. Reusable equipment must be dedicated to the client.
This prevents spores from traveling outside the room on clothing or shared medical devices.
3
Select the appropriate hand hygiene method.
Soap and water must be used instead of alcohol-based hand sanitizers.
Alcohol does not eradicate C. difficile spores; the mechanical friction of washing physically rinses the spores away.
4
Evaluate the remaining options against legal and delegation principles.
Delegating assessment to a UAP and posting the specific diagnosis publicly are both incorrect actions.
Assessment is strictly a nursing duty, and publicizing a diagnosis breaches client confidentiality.

Key Concept

Infection control measures for *Clostridioides difficile* require strict Contact Precautions, dedicated equipment, and handwashing with soap and water.
Estimated Time:1m 30s
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Topics

Standard and Transmission-Based Precautions

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