A nurse in the emergency department is assisting in the care of a 45-year-old female client who presents with abdominal symptoms. Complete the following sentence by using the lists of options: The nurse should first address the client’s ______, followed by the client’s _________.

The nurse should first address the client’s Hypokalemia, followed by the client’s Hypovolemia. Rationale for Correct Answers Hypokalemia (serum potassium 3.1 mEq/L; normal: 3.5–5.0 mEq/L) is the most immediate concern. Potassium is critical for cardiac and neuromuscular function. In Clostridium difficile infection (CDI), profuse diarrhea leads to significant potassium loss, increasing the risk of arrhythmias and muscle weakness. Prompt correction is essential to prevent life-threatening complications. Hypovolemia is the next priority. The client has signs of fluid loss: diarrhea, low blood pressure (104/56 mm Hg), elevated heart rate (102/min), and hemoconcentration (hematocrit 48%, hemoglobin 17 g/dL). These findings suggest volume depletion due to fluid loss from diarrhea. Hypovolemia can progress to shock if not corrected. Rationale for Incorrect Response 1 Options Hypertension is not present; the client is hypotensive, likely due to fluid loss. Hypoxemia is not a concern; oxygen saturation is 96% on room air, indicating adequate oxygenation. Fever (38.9°C) is expected in CDI but is not immediately life-threatening. It should be addressed after correcting electrolyte and fluid imbalances. Rationale for Incorrect Response 2 Options Dehydration is a general term; hypovolemia more accurately reflects the intravascular fluid deficit requiring urgent intervention. Hyperglycemia is not reported and is not relevant to this case. Tachycardia is a symptom of hypovolemia, not a primary issue. Treating the underlying fluid loss will resolve the elevated heart rate. Take-Home Points Clostridium difficile infection often follows recent antibiotic use and presents with watery diarrhea, fever, and abdominal cramping. Hypokalemia from diarrhea must be corrected promptly to prevent cardiac complications. Hypovolemia is a critical concern in CDI and requires fluid resuscitation. CDI should be differentiated from other causes of diarrhea, such as inflammatory bowel disease or viral gastroenteritis.