When a postoperative patient develops fever, abdominal pain, and diarrhea while on long-term antibiotics, what should the nurse evaluate for?

When a postoperative patient presents with fever, abdominal pain, and diarrhea, particularly while on long-term antibiotics, it is crucial to evaluate for a Clostridium difficile infection. This bacterium often proliferates in the gut when the normal flora has been disrupted by antibiotic therapy, leading to antibiotic-associated colitis. The symptoms of C. difficile infection can include watery diarrhea, abdominal discomfort, fever, and a sense of urgency, which align closely with the patient's presentation.

Clostridium difficile releases toxins that can cause damage to the intestinal lining, resulting in severe gastrointestinal symptoms. The context of recent antibiotic use significantly raises the suspicion for this infection, as antibiotics can eliminate the protective bacteria in the gut, allowing harmful bacteria like C. difficile to flourish.

While gastroenteritis is a possibility and dehydration could be a consequence of diarrhea, the direct link between antibiotic use and the risk of developing a Clostridium difficile infection makes this diagnosis particularly important to consider in this scenario. Appendicitis recurrence, although a concern in postoperative patients, is less likely given the specific symptoms and history provided. Thus, focusing on Clostridium difficile infection is the most appropriate and clinically relevant course of action.