A nurse is caring for an adult client on the medical-surgical unit. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Rationale for correct condition The client developed profuse watery diarrhea after antibiotic therapy, consistent with C. difficile colitis. Antibiotics disrupt normal gut flora, allowing C. difficile overgrowth. Hyperactive bowel sounds, abdominal cramping, and hypotension support this diagnosis. CT scan ruled out appendicitis. The client’s diarrhea began after cefazolin administration, a known risk factor for C. difficile. The frequency of stools every 30 minutes indicates severe colitis. Hypotension suggests fluid loss. Hyperactive bowel sounds confirm increased motility. CT imaging excluded surgical pathology. Rationale for correct actions Contact precautions prevent transmission of C. difficile spores, which survive on surfaces. IV fluids restore intravascular volume lost through diarrhea. Both actions directly address infection control and physiological stability. Placing the client on contact precautions is essential because C. difficile spores resist alcohol-based sanitizers and require soap and water hand hygiene. Gown and glove use prevents nosocomial spread. Isolation reduces risk to other patients. IV fluids are necessary because diarrhea causes hypovolemia and electrolyte imbalance. Normal blood pressure ranges 90–120/60–80 mm Hg, and the client’s drop to 105/68 indicates fluid depletion. IV fluids restore perfusion, prevent shock, and maintain renal function. Rationale for correct parameters Serum potassium must be monitored because diarrhea causes potassium loss. Blood pressure must be tracked to assess hydration status. Both parameters reflect complications of fluid and electrolyte imbalance. Serum potassium normal range is 3.5–5.0 mEq/L. Diarrhea leads to hypokalemia, which can cause arrhythmias, muscle weakness, and ileus. Monitoring ensures timely replacement and prevention of cardiac complications. Blood pressure reflects intravascular volume. The client’s decline from 149/87 to 105/68 shows significant fluid loss. Hypotension increases risk of shock. Monitoring ensures IV fluid therapy effectiveness and guides titration to maintain perfusion. Rationale for incorrect conditions Celiac disease involves gluten sensitivity, not acute antibiotic-associated diarrhea. Crohn’s disease is chronic, not sudden onset. Appendicitis presents with localized right lower quadrant pain and CT abnormalities, absent here. Celiac disease causes malabsorption and steatorrhea, not profuse watery diarrhea after antibiotics. Gluten-free diet is the intervention, not isolation. Crohn’s disease is a chronic inflammatory bowel disease with bloody stools and weight loss. It does not present acutely after antibiotic therapy. Appendicitis causes rebound tenderness, guarding, and CT abnormalities. The client’s CT was normal, ruling out appendicitis. Rationale for incorrect actions Barium swallow study is for esophageal disorders, not colitis. Gluten-free diet is for celiac disease. Emergent surgery is for appendicitis, not antibiotic-associated diarrhea. Barium swallow evaluates swallowing dysfunction, not infectious diarrhea. It is irrelevant here. Gluten-free diet treats celiac disease by reducing immune-mediated villous damage. It does not address C. difficile. Emergent surgery is indicated for appendicitis or perforation. CT scan excluded surgical pathology. Rationale for incorrect parameters Surgical incision monitoring applies to postoperative patients. Hemoglobin and hematocrit assess bleeding, not diarrhea. Steatorrhea is linked to malabsorption in celiac disease, not C. difficile colitis. Surgical incision infection monitoring is relevant only after surgery, absent here. Hemoglobin (normal 12–16 g/dL) and hematocrit (normal 36–48%) assess anemia or bleeding, not fluid loss. Steatorrhea indicates fat malabsorption in celiac disease, not infectious colitis. Test-taking strategy Identify key clinical clues Profuse watery diarrhea after antibiotics → C. difficile colitis Hypotension and hyperactive bowel sounds → fluid loss and increased motility Rule out incorrect conditions Celiac disease → chronic, gluten-related Crohn’s disease → chronic inflammatory, not acute Appendicitis → localized pain, abnormal CT Match actions to condition Contact precautions → infection control for C. difficile spores IV fluids → restore hydration and electrolytes Select parameters linked to complications Serum potassium → diarrhea causes hypokalemia Blood pressure → hypotension from fluid loss Eliminate distractors Barium swallow → esophageal disorders Gluten-free diet → celiac disease Surgery → appendicitis Steatorrhea → malabsorption Take home points C. difficile colitis is strongly associated with antibiotic use and presents with profuse watery diarrhea. Contact precautions are critical to prevent nosocomial spread of spores. Electrolyte monitoring, especially potassium, is essential in severe diarrhea. Differentiate C. difficile from celiac disease, Crohn’s disease, and appendicitis using onset, cause, and diagnostic findings.