A nurse is collecting data from a client who is 24 hr postoperative following a total knee arthroplasty. Which of the following findings on the operative leg should the nurse identify as a manifestation of a deep-vein thrombosis?

A. Increase in calf size: Swelling of the calf on the operative leg is a common early sign of deep-vein thrombosis (DVT) due to venous obstruction and pooling of blood. Postoperative patients, especially after lower-extremity orthopedic surgery, are at high risk because of immobility, endothelial injury, and hypercoagulability. Measurement and comparison of calf circumference can help detect unilateral enlargement suggestive of DVT. B. Capillary refill of 2 seconds: A capillary refill of 2 seconds is within normal limits, indicating adequate arterial perfusion. DVT affects venous return rather than arterial flow, so capillary refill is usually not altered. Normal refill does not exclude a thrombus but does not indicate its presence. C. Palpable cord-like vein: A palpable, cord-like vein may indicate thrombophlebitis, often superficial rather than deep. While it can sometimes occur with DVT, it is more characteristic of superficial vein involvement and is not as reliable an indicator of deep venous thrombosis. D. Extremity feels cool to the touch: A cool extremity is more commonly associated with arterial insufficiency or impaired arterial perfusion rather than DVT. DVT typically presents with warmth, redness, and edema in the affected limb due to inflammation and venous congestion.