A woman who has cracked and bleeding nipples is at increased risk for:

Choice A rationale

Difficulty breathing can indicate an anaphylactic reaction, a rare but serious side effect of Hemabate. It involves bronchoconstriction triggered by prostaglandin administration, usually necessitating emergency interventions.

Choice B rationale

Diarrhea is common due to prostaglandin's stimulation of smooth muscle in the gastrointestinal tract, leading to increased motility. This adverse effect often accompanies other systemic effects like cramping.

Choice C rationale

Hypotension, while possible, is less frequent and usually transient. It may result from the vasodilatory properties of prostaglandins but is not a primary side effect.

Choice D rationale

Palpitations occur less commonly and may arise if Hemabate induces systemic changes affecting heart rate, including reflex tachycardia secondary to other hemodynamic shifts.

Choice A rationale

Tone refers to uterine atony, the leading cause of postpartum hemorrhage. Tissue refers to retained placental fragments. Trauma includes lacerations or uterine rupture. Thrombin relates to coagulation disorders impacting clotting.

Choice B rationale

TOLAC (Trial of Labor After Cesarean) and thrombosis are unrelated to immediate hemorrhage management. Thrombosis generally involves venous clots, differing from thrombin, which concerns clotting factor deficiencies causing bleeding.

Choice C rationale

Tear and tolerance are non-specific terms lacking relevance to postpartum hemorrhage management. Time to search is impractical and unrelated to immediate intervention for hemorrhage or its causes.

Choice D rationale

"None of the above" is incorrect as the Four Ts (Tone, Tissue, Trauma, Thrombin) specifically address the primary causes of postpartum hemorrhage and are universally accepted in clinical guidelines.