GiantsFan

SATA=Select All That Apply

I took it a couple days ago, and I also passed w/75 questions. I had 15 SATA, 1 math, 1 diagram, and a DISPROPORTIONATE amount of infection control and prioritization questions. I felt like I answered more correct than I missed, so the test ending at 75 questions seemed like a good sign, and as it turns out, it was! Just try to relax. 85% of first-time NCLEX'ers pass in one try.

I agree with you in that you can also acquire CDAD w/o taking ABX. But according to page 760 of Harrison's Principles of Internal Medicine, "CDAD is a unique colon infection that's acquired almost exclusively in association with anitimicrobial use and the consequent disruption of the normal colonic flora." This was the key point I was trying to make. Other risk factors include older age, greater severity of illness, use of electronic rectal thermometers, enteral tube feedings, etc. Thanks for the website, I'll have to check it out!

Gowning and gloving would be an adequate way of protecting yourself. But one thing to remember about C. diff is it's almost entirely associated with antimicrobial use, particularly the second and third generation cephalosporins. Such ABX destroy normal flora, and in essence, create a breeding ground that is conducive to C. diff spore to vegetative cell colonization. Discontinuation of the antimicrobial agent will often resolve diarrhea symptoms in a few days. Sometimes further treatment is needed, first line Tx being Flagyl, second line Tx being Vancomycin. Recurrence ranges from 5-17%.Three events must occur to acquire CDAD (C. diff associated disease), A) Antibiotic use, B) C. diff acquisition, C) Inadequate IgG host response to toxin A of toxigenic C. diff.