A postpartum patient develops unilateral leg swelling and calf tenderness. What is the priority action?

• A. Apply leg massage immediately.
• B. Suspect DVT; notify provider; obtain duplex ultrasound; avoid leg massage; apply anticoagulation as ordered
• C. Elevate leg and apply heat.
• D. Administer IV fluids and monitor vital signs.

Answer: (B)

Unilateral leg swelling with calf tenderness in the postpartum period strongly suggests a deep vein thrombosis, and that risk can lead to a life-threatening pulmonary embolism if not promptly addressed. The priority is to suspect DVT, notify the provider, and obtain duplex ultrasound to confirm the diagnosis. While awaiting imaging and treatment, avoid any leg manipulation such as massage, because moving the clot can cause it to dislodge and travel to the lungs. If anticoagulation is ordered, start it as indicated to prevent clot growth and embolization. Elevating the leg or applying heat might offer some discomfort relief but do not treat the underlying clot, and IV fluids with vital signs monitoring are supportive but do not address the DVT itself.