Among postpartum findings, which should be assessed first due to the risk of thromboembolism?

• A. Nonreactive pupils
• B. Harsh lung sounds
• C. Reports swelling in her right calf
• D. Tender abdomen

Answer: (C)

Postpartum women are in a hypercoagulable state, with venous stasis and vessel injury increasing the risk of deep vein thrombosis and pulmonary embolism. The most important finding to assess first is unilateral leg swelling like a swollen calf, because it strongly suggests a DVT in the deep veins. Detecting a DVT early is critical since a clot can dislodge and travel to the lungs, causing a potentially life-threatening pulmonary embolism. If you encounter swelling in one calf, prioritize confirming whether a DVT is present and coordinate prompt testing and treatment as ordered.

The other signs point to different postpartum issues—nonreactive pupils raise neurologic concern, harsh lung sounds may indicate a respiratory problem, and a tender abdomen could reflect uterine or abdominal conditions—so they don’t carry the same immediate thromboembolism risk as unilateral leg swelling.