Which client should the nurse assess first based on postoperative status?

• A. A client with stable blood pressure and no pain
• B. A client with a fever of 101.3 and chest pain
• C. The client who had an abdominal hysterectomy yesterday and is reporting calf pain
• D. A client with a mild headache

Answer: (C)

The most urgent thing to assess is a postoperative patient who had abdominal surgery yesterday and is reporting calf pain. Postoperative immobility and a hypercoagulable state put surgical patients at high risk for deep vein thrombosis. Calf pain can indicate a DVT, and a DVT can dislodge and cause a pulmonary embolism, which can be life-threatening in the immediate recovery period. Because of that potential for rapid deterioration, this client warrants the promptest assessment to check for swelling, warmth, tenderness, and other signs of DVT and to coordinate urgent management if needed.

The other scenarios are concerning but less immediately threatening in this moment. A patient with stable blood pressure and no pain is stable and lower priority. A mild headache is not as urgent as a possible DVT with the risk of PE. A fever with chest pain is serious and requires rapid assessment as well, but the direct link between calf pain after recent surgery and a high-risk clot makes the DVT case the priority to assess first.