The patient with significant diarrhea due to a Clostridium difficile infection is at risk for which electrolyte imbalance?

Choice A reason: Hyperkalemia (high potassium) is unlikely in Clostridium difficile diarrhea, as significant fluid and electrolyte loss occurs. Potassium is lost in watery stools, reducing serum levels. Hyperkalemia is more associated with renal failure or tissue breakdown, where potassium release exceeds excretion, not diarrhea-related losses. Choice B reason: Hypokalemia (low potassium) occurs in Clostridium difficile diarrhea due to excessive potassium loss in frequent, watery stools. Potassium is a key intracellular ion, and its depletion disrupts membrane potentials, leading to muscle weakness, arrhythmias, and impaired cellular function, making this a critical imbalance to monitor. Choice C reason: Hypocalcemia (low calcium) is less common in diarrhea, as calcium loss is minimal compared to potassium or sodium. Clostridium difficile primarily causes fluid and electrolyte losses, with potassium and sodium being more significantly affected due to their higher concentration in intestinal secretions. Choice D reason: Hyponatremia (low sodium) can occur in diarrhea due to sodium loss in stools. However, potassium loss is more pronounced in Clostridium difficile infections, as watery diarrhea depletes potassium faster, making hypokalemia the primary concern, especially given its impact on cardiac and muscle function.