The nurse has completed a physical assessment on an older client. Which new assessment finding is most concerning for the presence of deep-venous thrombosis?

Question

1. Unequal, palpable pedal pulses
2. Shortness of breath after activity
3. Swelling in one leg with pitting edema
4. Bilateral calf pain after walking up a flight of stairs

Answer 1

3. Swelling in one leg with pitting edema

Explanation: 1. Unequal pulses is not a good assessment finding and does indicate a pathological issue. However, DVT does not typically cause a decrease in pulse amplitude before other symptoms are apparent.
2. Shortness of breath that occurs with activity is considered a normal assessment finding in the older adult client. As long as it resolves, it is not concerning. Dyspnea at rest is concerning for pulmonary embolism.
3. The hallmark of DVT is the rapid onset of unilateral leg swelling with pitting edema.
4. Bilateral calf pain may be a normal reaction to exercise of climbing stairs or may indicate peripheral vascular disease. Unilateral pain is significant for the presence of a DVT.