The 68-year-old patient is admitted after 5 days of extremely foul-smelling watery diarrhea with a temperature of 37.9°C, heart rate 118 bpm, and blood pressure 98/52 mmHg. The patient’s recent medical history is significant for being treated 2 weeks ago for a diverticulitis flare-up. Upon assessment, the patient is pale, diaphoretic, and has a tense, distended abdomen that he does not guard with palpation. Lab studies reveal an elevated creatinine (1.9 mg/dL), high white blood cell count (20,000 cells/mL), and normal hemoglobin and hematocrit. The nurse prepares to perform which diagnostic test for this patient?

Question

The 68-year-old patient is admitted after 5 days of extremely foul-smelling watery diarrhea with a temperature of 37.9&deg;C, heart rate 118 bpm, and blood pressure 98/52 mmHg. The patient&rsquo;s recent medical history is significant for being treated 2 weeks ago for a diverticulitis flare-up. Upon assessment, the patient is pale, diaphoretic, and has a tense, distended abdomen that he does not guard with palpation. Lab studies reveal an elevated creatinine (1.9 mg/dL), high white blood cell count (20,000 cells/mL), and normal hemoglobin and hematocrit. The nurse prepares to perform which diagnostic test for this patient?

Accepted Answer

Stool nucleic acid amplification testing. The patient is exhibiting symptoms of a Clostridium difficile superinfection after treatment for diverticulitis (which consists of IV and oral antibiotics), which is diagnosed by stool nucleic acid amplification testing to detect the C diff toxin. A blood culture might be necessary to determine if the patient is septic due to the superinfection, but this is not diagnostic of the superinfection. Stool culture is not diagnostic for C. diff, and neither is blood nucleic acid amplification testing.

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