C. Difficile for Certified Emergency Nursing (CEN)

C. Difficile

Definition/Etiology:

• Profuse diarrhea caused by Clostridium difficile – Gram-positive, anaerobic, spore-forming bacillus
• Gives rise to antibiotic-associated diarrhea

Pathophysiology:

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Clinical Presentation:

• Profuse, frequent diarrhea
• Abdominal cramping, pain
• Fever
• Nausea, loss of appetite, weight loss
• Dehydration, hypovolemia
• Kidney failure

Collaborative Management:

Interventions-

• Standard and contact precautions
• Stop antibiotics if possible
• IV fluid replacement
• Antiemetics
• Metronidazole, vancomycin, or fidaxomicin
• Stool transplant

Linchpins: (Key Points)

• Can lead to complications (electrolytes, skin breakdown, toxic megacolon)
• Caregivers MUST use soap and water for hand hygiene (not alcohol rub)
• Contact precautions, terminal clean for rooms