Stage 6 — Evaluate outcomes. Review the clinical trend and select the best evaluation and discharge infection-control plan.
Trend
Choose your responses, then check the answer.
Explanation
Trend interpretation Decreasing and then resolved unformed stools, restored hydration and renal function, stable abdominal and hemodynamic findings, normalized WBC, and treatment tolerance support clinical improvement. Complete the prescribed course and do not obtain a test of cure. Maintain contact precautions for at least 48 hours after diarrhea resolves or longer according to facility policy, perform EPA List K terminal cleaning at discharge, and teach home handwashing, environmental cleaning, medication completion, and recurrence warning signs.
Step 1 — Evaluate the whole trajectory Stool frequency, hydration, urine output, creatinine, WBC, temperature, abdominal findings, and hemodynamics improve together. No fulminant features appear.
Step 2 — Do not invent a laboratory cure endpoint Clinical recovery is not defined by a negative PCR or a rigid combination of formed stool, afebrile status, and normal WBC. Repeat testing after symptom resolution is not recommended because colonization can persist.
Step 3 — Close the environmental loop Continue precautions for at least 48 hours after diarrhea resolves or longer per policy and complete terminal cleaning with an EPA List K product used for its labeled contact time.
Step 4 — Prevent recurrence and household spread Finish therapy, wash hands with soap and water after toileting and before eating, clean the bathroom and high-touch surfaces appropriately, avoid unnecessary antibiotics, and report recurrent or worsening symptoms promptly.
NCLEX rule Evaluate clinical recovery, remaining transmission risk, and the next prevention plan without ordering a test of cure.
Scenario (Stage 6 — Evaluate outcomes)The client has had no unformed stools for 48 hours and is preparing for discharge while completing CDI therapy.
Clinical judgment targetRecognize improvement, avoid repeat testing, and preserve infection-control and recurrence-prevention measures.
Clinical CDI improvement — Improving diarrhea, hydration, abdominal findings, renal function, inflammatory markers, hemodynamics, and treatment tolerance rather than a negative test result.
Persistent colonization — Continued detection of C. difficile after symptoms resolve, which is why repeat testing is not used as proof of cure.
Terminal cleaning — Discharge or transfer cleaning with an EPA List K sporicidal product used according to label directions, including required wet-contact time.