# Stage 5 — Take action. Arrange the major decision points after recognizing suspected CDI. Infection-control setup, assessment, notification, and specimen preparation may overlap among team members.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=372797&lang=en  
> language: en  
> subject: Standard/Transmission-Based Precautions/Surgical Asepsis  
> category: SIPC

## Question

Stage 5 — Take action. Arrange the major decision points after recognizing suspected CDI. Infection-control setup, assessment, notification, and specimen preparation may overlap among team members.

Administer prescribed fidaxomicin or oral vancomycin and individualized fluid and electrolyte replacement, then monitor the response

Perform hand hygiene, don gown and gloves before room entry, post signage, and place dedicated equipment for subsequent care

Collect one unformed stool specimen promptly and send it through the facility diagnostic-stewardship algorithm before therapy when feasible

Initiate contact precautions immediately in the current location and arrange a single-patient room with a dedicated toilet or commode

Assess stool history, laxatives, hydration, abdomen, urine output, and instability; notify the provider, infection prevention, and stewardship teams

## Explanation

Decision sequence
Start contact precautions where the client is → use hand hygiene and PPE before entry and dedicate equipment → assess and notify the clinical and infection-prevention teams → collect and send one appropriate unformed specimen → administer ordered CDI therapy and supportive care and monitor. Do not move an unprotected client through the unit before precautions, and do not delay clinical notification until the laboratory has the sample.

## In-depth explanation

Step 1 — Contain immediately
Contact precautions begin on suspicion in the client's current location. Arrange a single room and dedicated toilet without treating movement as a prerequisite for basic PPE and isolation.

Step 2 — Protect every entry
Perform hand hygiene, don gown and gloves before entering, post clear signage, and dedicate equipment.

Step 3 — Assess and communicate early
Evaluate alternative causes, volume status, abdominal red flags, urine output, and instability. Notify the provider, infection prevention, and antimicrobial stewardship while specimen collection proceeds.

Step 4 — Use the right specimen and treatment
Send one unformed specimen before therapy when feasible, then implement the prescribed CDI agent and individualized hydration without delaying urgent care if the client deteriorates.

NCLEX rule
Sequence the decision gates, not every parallel action of the infection-control team.

## Clinical scenario

Scenario (Stage 5 — Take action)
The client has six new watery stools without recent laxative use after significant antibiotic exposure.

Clinical judgment target
Contain first, assess and escalate early, test the correct specimen, and begin ordered therapy without unsafe movement or communication delay.

## Key concepts

- **Preemptive contact precautions** — Isolation initiated when clinically significant unexplained diarrhea raises CDI concern, before laboratory confirmation.
- **Unformed stool specimen** — A specimen that takes the shape of its container and is appropriate for CDI testing in a symptomatic client under facility criteria.
- **Antimicrobial stewardship review** — Prompt reassessment of whether non-CDI antibiotics can be stopped, narrowed, or shortened while preserving treatment of the original infection.

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