A client in the third trimester complains of leg cramps while reclining. What should the nurse check for first?

• A. Signs of dehydration
• B. Signs of thrombophlebitis
• C. Signs of preterm labor
• D. Signs of gestational diabetes

Answer: (B)

In this scenario, it is vital for the nurse to assess for signs of thrombophlebitis first. Leg cramps in a pregnant client, especially in the third trimester, may be indicative of underlying circulatory issues, including thrombophlebitis, which is the inflammation of a vein caused by a blood clot. The risk of thrombosis increases during pregnancy due to physiological changes, including increased blood volume and changes in blood flow dynamics, particularly when a woman is reclining for extended periods.

Identifying signs of thrombophlebitis such as swelling, redness, warmth, or tenderness in the leg can prompt timely intervention, as this condition can lead to serious complications if not addressed. While dehydration, preterm labor, and gestational diabetes are important considerations in managing care during pregnancy, the acute concern of possible thrombophlebitis takes precedence due to its potential for rapid progression and the associated risk of deep vein thrombosis (DVT). Thus, the initial priority in this situation is to rule out any circulatory complications before exploring other potential causes of leg cramps.