Which clinical manifestations would a nurse recognize as indicators of a possible pulmonary embolism in a client who has undergone a total hip replacement?

In the context of a client who has undergone a total hip replacement, recognizing unilateral chest pain as a clinical manifestation is crucial for the identification of a potential pulmonary embolism (PE). A PE occurs when a blood clot travels to the lungs, often originating from deep vein thrombosis (DVT) in the legs, a common complication after hip surgeries.

Unilateral chest pain is indicative of a problem in the chest area and may suggest that a clot has traveled from the legs to the pulmonary circulation, blocking a pulmonary artery. This can cause significant respiratory distress and stress on the cardiovascular system. The pain is often pleuritic in nature, meaning it may worsen with deep breaths, coughing, or movement.

The other manifestations provided, while they can be serious and warrant clinical attention, do not directly point to a pulmonary embolism. Gradual leg swelling is more suggestive of DVT rather than an immediate indication of PE. Localized calf tenderness also points toward DVT and not necessarily PE. A slight fever can occur postoperatively for various reasons but is not specific for PE.

Thus, unilateral chest pain stands out as a critical sign in monitoring and identifying a pulmonary embolism in this postoperative context, guiding immediate assessment and intervention by healthcare professionals.