# A client has a first recurrence of nonfulminant Clostridioides difficile infection 3 weeks after completing vancomycin. Which actions are appropriate? Select all that apply.

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> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client has a first recurrence of nonfulminant Clostridioides difficile infection 3 weeks after completing vancomycin. Which actions are appropriate? Select all that apply.

1Administer prescribed fidaxomicin and document stool-frequency response.
2Review and discontinue nonessential systemic antibiotics and acid-suppressive therapy with the prescriber.
3Give an antimotility drug routinely before the treatment plan is reviewed.
4Maintain enteric infection-control precautions and communicate the recurrence.
5Assess recurrence risk and whether authorized adjunctive bezlotoxumab is appropriate.
6Use a positive test alone to treat an asymptomatic client indefinitely.

## Explanation

For recurrent CDI, fidaxomicin is preferred when feasible, modifiable antibiotic pressure should be reduced, infection-control measures continue, and recurrence-risk adjuncts may be considered.

## In-depth explanation

Quick answer
Treat the recurrence while reducing continued microbiome pressure and transmission risk.

Why this is correct
IDSA/SHEA suggests fidaxomicin over a standard vancomycin course for recurrent CDI and supports bezlotoxumab consideration in selected clients with a recent recurrence. Clinical symptoms, not an isolated test, guide treatment.

Easy analogy or mental picture
Remove the fuel, target the organism, and block another spark from spreading.

Memory hook
Recurrent CDI: fidaxomicin, stewardship, precautions, recurrence-risk review.

NCLEX decision rule
Combine effective therapy with removal of avoidable drivers and monitoring of hydration, stool burden, abdominal findings, and recurrence.

Why the other choices are wrong
Routine antimotility treatment can obscure deterioration, and indefinite treatment of asymptomatic colonization is not the recommended target.References
1IDSA/SHEA 2021 Focused Update for C. difficile InfectionFidaxomicin preference for initial and recurrent CDI and bezlotoxumab consideration for recurrence risk

## Clinical scenario

Recurrent CDI plan
Track stool frequency, hydration, creatinine, white-cell count, abdominal findings, antibiotic exposure, infection-control measures, and recurrence risk.

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