C. Difficile

C. Difficile

1. Fever

   • Monitor temp and for chills
   • Monitor hydration Status
   • Give ice chips and encourage fluids
   • Administer Antipyretics as ordered
   • Monitor for diaphoresis and skin break down

2. Diarrhea

   • Monitor for skin breakdown
   • Monitor for fluid and electrolyte imbalance
   • Administer Fluids and electrolyte replacement as ordered
   • Assess bowel sounds
   • Monitor I&O
   • Encourage high fiber foods
   • Keep perianal area clean and dry
   • Treat Pt with dignety

3. Pain

   • Assess level of abominal pain and cramping
   • Administer pain medications as ordered
   • Turn / reposition q2h
   • Distractions (TV, music, magazine)

4. Labs/test

   • Colonoscopy
     • Administer enema PRN
   • Culture stool
     • Positive for C. Diff
   • Serum electrolyte leveles
     • Serum K+ 2 ..7mmol/L - Hypokalemia
       • Pt on Cardiac monitor

5. Medications

   • Vancomycin
     • MOA: Bind to cell wall; cause cell death
     • AE: Nephrotoxicity, Phlebitis
     • MUST be given orally for C. Diff
   • Potassium Chloride
     • MOA: Activate enzyme reaction and nerve impulses
     • AE: Arrhythmias, confusion, weakness, GI discomfort
     • NEVER push potassium
   • Magnesium Oxide
     • MOA: Maintains electrolyte homeostasis
     • AE: Hypermagnesia
     • Monitor for S/Sx of electrolyte imbalance
   • Acetaminphen
     • MOA: Inhibits prostaglandin sythesis
     • AE: Hepatoxicity
     • Assess liver function before administration. Monitor temperature for effectiveness.
   • Morphine
     • MOA: Binds to opiate receptors. Alters preception of painful stimuli. Generalized CNS depression
     • AE: RESPIRATORY DEPRESSION, Confussion, Sedation,, Hypotension, Constipation
     • Monitor respiratory status and VS. Assess LOC and sedation level. Assess pain level, type, location.
   • Sodium Phosphate
     • MOA: Maintain electrolyte balance
     • AE: Hypernatremia, Hyperphosphatemia
     • Monitor Serum electrolyte levels and for S/SX of electrolyte imbalance

6. Education

   • Avoid spicy, fatty, fried food
   • Take medications as directed
   • Maintain hydration and proper diet
   • S/Sx of fluid and electrolyte imbalance
   • Perianal hygiene