A client diagnosed with a pulmonary embolism is placed on a continuous Heparin infusion. A nurse should notify the health care provider for which of the following findings?

A. Vanilla ice cream: While ice cream may be soothing for a sore throat, it is not the most nutritious option for a client with bacterial pharyngitis. Although it provides calories and can help with throat discomfort, it lacks essential nutrients that support recovery and may not help with hydration, which is critical during illness.
B. Chicken noodle soup: This option can be beneficial due to its warm temperature and potential nutritional value, including protein and hydration. However, the heat of the soup may irritate a sore throat further, especially if it is too hot. It can be a good option, but care should be taken to ensure it is at a comfortable temperature for the client.
C. Hot herbal tea: While herbal tea can provide hydration and soothing effects, it may also irritate a sore throat if served too hot. The temperature of the tea is a consideration, as consuming very hot liquids can exacerbate throat discomfort. Therefore, while it can be helpful, it may not be the best option for promoting comfort.
D. Fruit-flavored popsicles: This is the most recommended option for promoting nutrition during treatment for bacterial pharyngitis. Popsicles are cold, which can soothe a sore throat and reduce inflammation. They are also hydrating, easy to swallow, and can provide some calories, making them a good choice for maintaining nutrition and comfort during recovery. This option balances soothing relief with hydration and nutrition effectively.

• Clostridium difficile infection is likely because the client has pneumonia and is receiving ceftriaxone, an antibiotic known to disrupt gut flora and cause opportunistic infections like C. difficile. The presence of frequent, liquid, foul-smelling stools further supports this diagnosis.
• Myocardial infarction is unlikely because while the client has chest pain, it is pleuritic and related to inspiration rather than the typical crushing, non-pleuritic chest pain seen in an MI. There is no mention of radiating pain, diaphoresis, or hemodynamic instability.
• Pulmonary edema is unlikely since it typically presents with dyspnea, crackles throughout the lung fields, pink frothy sputum, and signs of fluid overload such as peripheral edema and weight gain. The client’s symptoms do not align with this condition.
• Pulmonary embolism is also unlikely, as it presents with sudden-onset dyspnea, pleuritic chest pain, tachycardia, and often calf swelling or a history of deep vein thrombosis. The client lacks the risk factors and clinical signs of PE.
• Placing the client on contact precautions is necessary because C. difficile is highly contagious and spreads through the fecal-oral route. Gloves and gowns should be used to prevent transmission.
• Obtaining a stool culture is necessary to confirm the presence of C. difficile toxins in the stool, which is essential for accurate diagnosis and treatment.
• Requesting a prescription for an anticoagulant is not necessary because the client does not show any signs of thromboembolic disease such as deep vein thrombosis or pulmonary embolism. Anticoagulation could increase the risk of bleeding in the gastrointestinal tract, which would worsen the diarrhea.
• Requesting a prescription for a diuretic is not needed because the client is more likely to be dehydrated due to diarrhea. Diuretics would exacerbate fluid loss and electrolyte imbalances.
• Restricting fluids is not appropriate because dehydration is a major concern with C. difficile infection. Instead, fluid intake should be encouraged to prevent complications from excessive fluid loss.
• Level of consciousness should be monitored because severe dehydration and electrolyte imbalances can lead to confusion, weakness, and altered mental status. While altered mental status can occur with severe dehydration or sepsis, it is not the primary concern at this stage.
• Potassium level should be monitored because diarrhea can cause significant potassium loss, leading to hypokalemia, which can result in muscle weakness, cardiac arrhythmias, and fatigue.
• Urine output is not the most specific parameter for monitoring C. difficile infection. While dehydration is a concern, tracking electrolyte levels and neurological status is more critical.
• Calf swelling is not relevant since the client does not have signs or risk factors for deep vein thrombosis or pulmonary embolism.
• Weight: C. difficile infection can cause significant fluid loss due to persistent diarrhea, leading to dehydration and weight loss. Tracking daily weight helps assess hydration status and the effectiveness of fluid replacement therapy.