Author Question: The nurse is assessing a cognitively impaired older adult client and observes a leaking of liquid ... (Read 109 times)

Diane · **on:** Jul 23, 2018

The nurse is assessing a cognitively impaired older adult client and observes a leaking of liquid stool from the rectum. The nurse's initial intervention for this client is to:

1. Determine if the client has been eating sufficiently, especially fiber-rich foods
2. Determine how long it has been since the client had a normal-size, formed stool
3. Perform a digital examination of the rectum to determine the presence of stool
4. Call the health care provider to get a prescription for an antidiarrheal medication

Question 2

The nurse is providing ancillary personnel with instructions regarding the proper methods to im-plement when caring for a client with a Clostridium difficile infection.

Which of the following practices will have the greatest impact on containment of the bacteria and thus prevention of cross-contamination?
1. Frequent in-services on transmission modes of C. difficile
2. Practice of proper hand hygiene by all staff
3. Appropriate handling of contaminated linen
4. Stool cultures on all suspected carriers

akpaschal · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: 1
When a continuous oozing of diarrhea stool occurs, suspect impaction. The liquid portion of feces located higher in the colon seeps around the impacted mass. An obvious sign of impaction is the inability to pass a stool for several days, despite the repeated urge to defecate. The digital exam-ination should be performed after it has been determined that the client has been without a nor-mal bowel movement for several days. Although the remaining options are not inappropriate, they would not be the initial intervention.

Answer to Question 2

ANS: 2
Poor hand hygiene and erratic disinfection practices result in the transmission of C. difficile. Stool cultures are useful in the diagnosis, not the prevention, of C. difficile. Although the other options are appropriate, they do not have the most impact on preventing the spread of these bacteria.