A nurse is admitting a client who was prescribed antibiotic therapy and now has a Clostridium difficile infection. Which of the following actions should the nurse take?

Choice A rationale Alcohol-based hand sanitizers are ineffective against Clostridium difficile because they do not kill the spores produced by the bacteria. The mechanical action of washing hands with antimicrobial soap and water is the only effective way to physically remove these resilient spores from the skin. The nurse must perform hand hygiene with soap and water after every contact with the client or their environment to prevent cross-contamination to other clients and healthcare workers in the facility. Choice B rationale Clostridium difficile is transmitted via the feca-oral route through contact with contaminated surfaces or hands, not through respiratory droplets. Therefore, having the client wear a mask when leaving the room is not a required or effective intervention for preventing the spread of this specific infection. The focus of isolation precautions for this client should be on rigorous contact precautions, including the use of gloves and gowns, rather than respiratory or droplet precautions used for airborne pathogens. Choice C rationale Disinfecting equipment daily and after each use is essential because Clostridium difficile spores can survive on environmental surfaces for several months. High-touch surfaces and medical equipment used for the client must be cleaned with a bleach-based solution or a sporicidal agent to ensure the spores are destroyed. Regular disinfection reduces the environmental reservoir of the bacteria, which is a critical step in breaking the chain of infection within a healthcare setting and protecting others. Choice D rationale A protective environment is designed for immunocompromised clients, such as those undergoing bone marrow transplants, to protect them from external pathogens. It typically involves positive-pressure airflow and HEPA filtration. A client with a Clostridium difficile infection requires contact precautions in a private room to prevent the spread of the infection to others, rather than a protective environment. The goal is containment of the pathogen within the room to prevent transmission throughout the unit.