A transgender client is taking transdermal estrogen. What assessment finding does the nurse report immediately to the primary health care provider?

A. Fatigue: Mild fatigue can occur with hormone therapy but is generally non-urgent and expected as a transient side effect. It does not usually indicate a life-threatening complication of estrogen therapy. B. Breast tenderness: Breast tenderness is a common effect of estrogen therapy due to hormonal stimulation of breast tissue. It is expected and does not require immediate intervention unless accompanied by unusual swelling or masses. C. Headaches: Headaches may occur as a side effect of estrogen therapy, but unless they are severe, sudden, or associated with neurological deficits, they are not immediately life-threatening. Monitoring and documentation are appropriate. D. Red, swollen calf: A red, swollen calf can indicate deep vein thrombosis (DVT), a serious and potentially life-threatening complication of estrogen therapy. Estrogen increases the risk of hypercoagulability, and prompt reporting to the healthcare provider is critical for timely diagnosis and management to prevent complications such as pulmonary embolism.