Question

Evy Stroup, RN, works as a new nurse infection preventionist at the Altoona Hospital, an acute care hospital in Maryland. Her role is to conduct surveillance of infections acquired within the health care setting. In addition to infection surveillance, Evy implements evidence-based protocols to ensure that isolation precautions are followed to prevent infection spread within the hospital. Evy notices an increase in the number of C. difficile infections among patients in the ICU. On Monday afternoon, Evy receives a call from Josiah Lucas, the ICU staff nurse, regarding a patient, Mr. Smith, who has developed a severe bout of diarrhea over the past two days during day shift. According to the Josiah, the patient has been in the ICU for 10 days and did not have any prior gastrointestinal symptoms. Evy asks Josiah about the night shift report, attempting to determine if the night RN documented the recent diarrheal symptoms. Josiah said that the night shift RN was down-sized and apparently did not document any information in the chart. The 70-year-old patient was admitted from Laurel Walk nursing home for bilateral pneumonia and was placed on a ventilator on the day of admission. The patient was placed on three different types of antibiotics to treat the pneumonia. Furthermore, because the patient was on a ventilator, the hospitalist prescribed a proton-pump inhibitor medication to prevent acid reflux. Josiah informs Evy that Mr. Smith came off the ventilator four days ago and was doing well until two days ago. Also, Josiah noted that the patient’s rectal temperature is 102.5. Evy calls Josiah to inform him of her discussion with her colleague and the findings from the CDC website. Before Evy could further explain, Josiah interrupts and says that Mr. Smith got worse and requires an emergency procedure. His abdominal CT showed that he had fulminant toxic megacolon, likely due to an infectious etiology. Evy is concerned that the patient Has not been put on isolation precaution, which is required for C. difficile infection. She is worried that the patient may be actively infectious and potentially spreading the infection to others. Critical Thinking: 1. What subjective data for Mr Smith indicates that he is at risk for C. difficile

Answer 1

Subjective data for Mr. Smith that indicates he is at risk for C. difficile infection includes severe diarrhea, high temperature, antibiotic usage, and use of a proton-pump inhibitor.

Step-by-step explanation:

Subjective data for Mr. Smith that indicates he is at risk for C. difficile infection includes:

• Severe bout of diarrhea over the past two days
• Rectal temperature of 102.5
• Has been on three different types of antibiotics.
• Has been on a proton-pump inhibitor medication to prevent acid reflux.

These factors, along with the fact that Mr. Smith has been in the ICU for 10 days, makes him more susceptible to C. difficile infection.