A hospitalized client with frequent watery diarrhea tests positive for Clostridioides difficile and has a prescription for oral vancomycin. Which nursing action is appropriate?
1Administer oral vancomycin, use contact precautions with gown and gloves, and wash with soap and water after likely spore contact.✓ Correct answer
2Replace oral vancomycin with intravenous vancomycin because systemic delivery produces higher colonic concentrations.
3Use airborne precautions and an N95 respirator because C. difficile spores spread primarily through room air.
4Give an antimotility medication and continue unnecessary antibiotics so bowel frequency decreases during treatment.
Explanation
Oral vancomycin is an accepted treatment for C. difficile infection because it acts within the intestinal lumen; intravenous vancomycin does not substitute for this indication. Contact precautions, gown and gloves, and appropriate spore-focused hand hygiene and environmental measures limit transmission. Airborne isolation is not indicated, and antimotility therapy or unnecessary antibiotics can worsen management concerns.
Clinical reasoning C. difficile is transmitted through hardy spores and causes colitis within the bowel. Treatment and infection control therefore target the colonic lumen and contact transmission.
Decision rule Use the prescribed oral agent, initiate contact precautions, wear gown and gloves, and use soap and water when spore contact is likely. Reassess other antibiotics for necessity.