A nurse is contributing to the plan of care for a client who is 2 days postoperative and reports pain in their calf. Which of the following actions should the nurse include?

Postoperative clients are at increased risk for venous thromboembolism due to immobility, vascular injury, and hypercoagulable states associated with surgery. Calf pain in this context is concerning for deep vein thrombosis (DVT), which can potentially progress to pulmonary embolism if the clot dislodges. Early recognition and monitoring for systemic complications are essential to prevent life-threatening outcomes. Nursing care focuses on avoiding actions that dislodge a clot and monitoring for respiratory compromise. Rationale: A. Instructing the client to massage the calf gently is contraindicated because it may dislodge a thrombus if a deep vein thrombosis is present. This increases the risk of embolization to the lungs, leading to a pulmonary embolism. Massage is therefore avoided in clients with suspected or confirmed DVT. B. Maintaining the leg in a dependent position is not recommended because it can increase venous stasis and worsen swelling in the affected extremity. The appropriate positioning for suspected DVT is elevation to promote venous return. A dependent position may exacerbate symptoms and increase discomfort. C. Monitoring the client's pulse oximetry is appropriate because a complication of DVT is pulmonary embolism, which can impair oxygen exchange. A drop in oxygen saturation may be an early indicator of embolic migration to the lungs. Continuous or frequent monitoring allows early detection of respiratory compromise and prompt intervention. D. Applying a cold compress to the calf is not an appropriate intervention for suspected DVT because it does not address the underlying clot and may cause vasoconstriction without benefit. The priority is to avoid interventions that could dislodge the clot and instead monitor for complications. Warmth, not cold, is sometimes used for comfort, but only under provider guidance and not in acute suspicion of thrombosis.