امرأة عمرها ٦٩ سنة في اليوم الثاني بعد استبدال مفصل الركبة، لم تبدأ المشي بعد. تشتكي ألماً وتورماً ودفئاً في ربلة الساق اليمنى، ومحيطها أكبر من اليسرى بـ ٣ سم. العلامات الحيوية: النبض ٩٢، التشبع ٩٧٪، الحرارة ٣٧٫٤. ما أول إجراء؟

A 69-year-old woman on day 2 after knee replacement has not yet started walking. She reports pain, swelling and warmth in the right calf, which is 3 cm larger than the left. HR 92, SpO2 97%, T 37.4 °C. What is the first action?

1. Apply intermittent pneumatic compression to the same leg
2. Massage the calf to ease the pain and improve flow
3. Encourage brisk walking to break up the clot
4. Keep the client in bed and notify the physician for a Doppler scan

Answer: D) Keep the client in bed and notify the physician for a Doppler scan. This suggests deep vein thrombosis. Massage and pneumatic compression of the affected leg are avoided because they may dislodge the clot. The physician is notified to confirm and start anticoagulation.