Parents of a school-age child with hemophilia ask the nurse, "Which sports are recommended for children with hemophilia?" Which sport should the nurse recommend?

Choice A rationale:

Morning sickness, which refers to nausea and vomiting during pregnancy, is a common symptom but not a definitive sign of pregnancy. It can also be caused by various other factors such as food poisoning or gastrointestinal issues. Therefore, it is not a positive sign of pregnancy.

Choice B rationale:

Quickening, which refers to the first fetal movements felt by the mother, is a subjective sign of pregnancy. It is not a definitive indication of pregnancy as it can be mistaken for other abdominal sensations. Quickening usually occurs between 18 to 22 weeks of gestation, making it a later sign and not an early positive sign of pregnancy.

Choice C rationale:

A positive pregnancy test, specifically a blood or urine test detecting human chorionic gonadotropin (hCG), is a reliable indicator of pregnancy. However, it is a biochemical sign and not a physical sign. It does not directly confirm the presence of the fetus or its well-being, making it less specific than auscultating the fetal heartbeat.

Choice D rationale:

Fetal heartbeat auscultated with Doppler/fetoscope is a positive sign of pregnancy. The healthcare provider can hear the fetal heartbeat using a Doppler ultrasound device or fetoscope, confirming the presence of a viable pregnancy. This sign is considered positive because it directly indicates the presence of a developing fetus, providing reassurance about the pregnancy status. Fetal heartbeat can usually be detected around 10 to 12 weeks of gestation.

Choice A rationale:

Afterbirth hemorrhage, or postpartum hemorrhage (PPH), is a significant concern after childbirth. One of the common causes is retained placental fragments. When placental tissue is not completely expelled after delivery, it can lead to continuous bleeding. This condition requires prompt medical intervention, often through uterine exploration and removal of the retained tissue.

Choice B rationale:

Unrepaired vaginal lacerations can cause bleeding, but they are usually identified and repaired immediately after delivery. In this case, the woman gave birth 4 hours ago, so unrepaired lacerations would have been addressed during the delivery process.

Choice C rationale:

Uterine atony, which is the lack of normal uterine muscle tone, can cause postpartum hemorrhage. However, in this scenario, the woman was given Pitocin, which is an oxytocic medication used to prevent or treat uterine atony by inducing uterine contractions. Therefore, uterine atony is less likely to be the cause in this case.

Choice D rationale:

Puerperal infection, also known as postpartum infection, can cause fever, uterine tenderness, and foul-smelling discharge. While it can lead to complications, it is not the most likely cause of significant bleeding in this situation.