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One of the FIRST signs of retroperitoneal hemorrhage after a PCI includes:

  1. Flank ecchymosis

  2. Increased urine output

  3. Swelling in the limbs

  4. Tachypnea

The correct answer is: Flank ecchymosis

Flank ecchymosis is considered one of the first signs of retroperitoneal hemorrhage after a PCI because it is a classic indicator of bleeding into the retroperitoneal space. The retroperitoneum is an area behind the peritoneum that contains major blood vessels and organs. When there is bleeding in this space, blood may track down and cause bruising around the flank area. Increased urine output (choice B) is not typically associated with retroperitoneal hemorrhage after a PCI. Swelling in the limbs (choice C) and tachypnea (choice D) are also not commonly seen as early signs of this complication.