A 55-year-old client with moderate-to-severe vasomotor sympt…

A 55-yeаr-оld client with mоderаte-tо-severe vаsomotor symptoms is started on combined hormone replacement therapy (estrogen + progestin). Which finding, if reported by the client during a follow-up call, requires the nurse to instruct the client to seek IMMEDIATE medical attention rather than waiting for a scheduled appointment?