The nurse suspects that a client with disseminated intravascular coagulation has developed internal bleeding. Which condition supports the nurse's suspicion?

Rationale: A. This is typically a sign of right-sided heart failure or fluid overload. It does not indicate internal hemorrhage and is unrelated to the coagulopathy seen in DIC. B. When internal bleeding occurs, the body usually responds with tachycardia as a compensatory mechanism to maintain cardiac output and tissue perfusion. A slow heart rate would not be expected in acute hemorrhage. C. Hypovolemia from internal bleeding generally causes hypotension due to decreased circulating blood volume. Elevated blood pressure does not support the suspicion of bleeding. D. Abdominal distension can indicate internal hemorrhage, such as hemoperitoneum. In DIC, clotting factors are depleted, leading to spontaneous bleeding. Blood may accumulate in body cavities, causing swelling or distension that is palpable or visible on physical assessment. Additional supporting signs may include abdominal pain, tenderness, or a firm abdomen. Recognizing these signs early allows timely intervention to prevent hypovolemic shock and organ damage.