A nurse is caring for a client who is at 32 weeks of gestation and has deep-vein thrombosis. Which of the following actions should the nurse take?

In a pregnant client with deep-vein thrombosis (DVT), monitoring is a critical nursing responsibility. Measuring and recording leg circumferences daily allows the nurse to objectively track changes in edema and thrombus progression, providing an early indicator of worsening DVT or extension. Warfarin is contraindicated during pregnancy, particularly beyond the first trimester, because it crosses the placenta and is teratogenic; low-molecular-weight heparin (such as enoxaparin) or unfractionated heparin is the anticoagulant of choice because these agents do not cross the placenta. Placing the client with her knees in a sharply flexed position is contraindicated because it impairs venous return and increases the risk of clot propagation. Red blood cell (RBC) monitoring every four hours is not indicated for DVT management; coagulation studies such as anti-Xa levels (if using LMWH) or aPTT (if using unfractionated heparin) are more appropriate. Daily leg circumference measurement is a straightforward, non-pharmacological nursing assessment that directly monitors disease progression and is appropriate for any stage of pregnancy.