- Acute Pain related to C. difficile infection and Inflammatory process due to skin breakdown as evidenced by Expression of pain and Positioning to ease the pain
- Deficient Fluid Volume related to Insufficient fluid intake and loose watery stools more than 3 times per day as evidenced by Altered skin turgor and Increased urine concentration
- Deficient Knowledge related to Inadequate knowledge of resources and Inadequate participation in care planning as evidenced by Inaccurate follow-through of instructions and Poor adherence to the care plan
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviors | Acute Pain related to C. difficile infection and Inflammatory process due to skin breakdown as evidenced by Expression of pain and Positioning to ease the pain | Patient will report pain 2/10 or less using a pain scale. Patient will report an absence of cramping or abdominal tenderness. Patient will report relief from perianal discomfort. | 1. Administer specified medications as indicated. Metronidazole and vancomycin are considered the mainstay antibiotic treatment options for C. difficile infection. NSAIDs like naproxen, ibuprofen, and indomethacin are contraindicated as they can increase the risk of C. difficile infection. Opioids are also found to increase the risk of severe disease, complications, longer hospital stays, and readmission. 2. Encourage the patient to use non-pharmacologic pain relief methods. Instruct on the use of positioning, rest, distraction, breathing techniques, and heating pads to promote comfort. 3. Offer pain relief to irritated skin. Frequent diarrhea from C. difficile can cause skin irritation to the perianal area. Offer comfort measures such as a Sitz bath and cooling ointments. 4. Involve the patient’s family in patient care. Since C. difficile is highly contagious it can be an isolating illness. Instruct family members on proper precautions to prevent transmission but encourage contact to reduce feelings of pain and discomfort. | Patient reported pain 2/10 or less using a pain scale. Patient reported an absence of cramping or abdominal tenderness. Patient reported relief from perianal discomfort. |
| Subjective data: Verbalizes Diarrhoea -Insufficient fluid intake Objective data: -Altered skin turgor -Decreased blood pressure -Dry skin -Increased body temperature -Increased heart rate -Increased urine concentration -Sudden weight loss | Deficient Fluid Volume related to Insufficient fluid intake and loose watery stools more than 3 times per day as evidenced by Altered skin turgor and Increased urine concentration | Patient will remain free of any signs of dehydration and exhibit normal vital signs. Patient will experience no more than two loose stools per day. Patient will consume at least 500 mL of water per day if not contraindicated. | 1. Monitor fluid intake and output. Urine output is an accurate indicator of fluid balance and poor urine output along with a dark urine colour can indicate dehydration. 2. Monitor the patient’s bowel movements. Since patients with C. difficile infection often exhibit loose watery stools, it is essential to monitor the number of bowel movements and observe for complications such as blood or pus in the stool. 3. Provide oral or intravenous fluid replacement therapy. Fluid replacement is essential to restore circulatory volume and correct electrolyte imbalances in patients with C. difficile infection. Continuous IV fluids will likely be ordered and the patient should be encouraged to consume water and other fluids. 4. Administer antibiotics as indicated. Antibiotic use causes C. difficile, but it is also the required treatment. The offending antibiotic should be discontinued. Metronidazole is the recommended antibiotic to treat C. difficile and prevent diarrhoea | Patient remained free of any signs of dehydration and exhibit normal vital signs. Patient experienced no more than two loose stools per day. Patient consumed more than 500 mL of water per day. |
| Subjective data: Verbalizes poor understanding Seeks additional information Denial of a need to learn Objective data: Inaccurate demonstration or teach-back of instructions Inability to recall instructions Exhibiting aggression or irritability regarding teaching follow-up Poor adherence to recommended treatment or worsening medical condition | Deficient Knowledge related to Inadequate knowledge of resources and Inadequate participation in care planning as evidenced by Inaccurate follow-through of instructions and Poor adherence to the care plan | Patient will adhere to infection control interventions to prevent the spread of C. difficile. Patient will not experience a recurrence of C. difficile infection. | 1. Educate the patient about symptoms requiring immediate medical attention. Educate on symptoms (loose watery stools, blood or pus in the stool, fever, and vertigo) that need to be reported right away to prevent progression and complications. 2. Educate the patient & family about infection control interventions. Frequent handwashing before and after patient contact is essential in preventing the spread of C. difficile infection. Remind family members that alcohol-based hand sanitizers do not kill C. difficile spores. 3. Educate staff and visitors. Patients with C. difficile are placed on contact precautions. A gown and gloves must be worn when entering their room and providing care and disposed of after. 4. Educate on possible surgical treatments. Fecal transplants are an experimental treatment used to restore healthy bacteria into the patient’s colon from a donor. This treatment may be effective for patients with recurrent C. difficile infections. 5. Instruct on medications to prevent reinfection. The patient may be instructed to continue taking probiotics that maintain the “good” bacteria in the gut. | Patient adhered to infection control interventions to prevent the spread of C. difficile. Patient experienced a recurrence of C. difficile infection. |