Which statement is appropriate for postpartum discharge instructions regarding venous thromboembolism?

• A. Walk vigorously to strengthen legs.
• B. Limit fluids to reduce swelling.
• C. Apply tight stockings continuously.
• D. Notify the provider immediately if either leg becomes swollen.

Answer: (D)

Postpartum has a higher risk of venous thromboembolism because the body remains in a hypercoagulable state after delivery. A critical sign to watch for is swelling in the legs, which can indicate a deep vein thrombosis that could travel to the lungs and cause a life-threatening pulmonary embolism if not treated promptly. Therefore, the best discharge instruction is to notify the provider immediately if either leg becomes swollen, so evaluation and treatment can occur quickly.

Ambulation and movement are helpful in recovery, but should be gentle rather than vigorous. Hydration should be maintained rather than restricted, as adequate fluids support circulation. Compression stockings, if prescribed, should be used according to provider instructions and skin should be checked, rather than worn continuously without guidance.