Final answer:
The best indications of a vulva hematoma are complaints of intense pain and signs of heavy bruising, as these symptoms directly reflect the underlying blood accumulation and tissue pressure.
Step-by-step explanation:
The presence of a vulva hematoma in a postpartum (PP) woman who has received epidural anesthesia can be indicated by a few assessment findings. Among the options provided, complaints of intense pain and signs of heavy bruising are the most indicative of a hematoma. Complaints of a tearing sensation may suggest a tear or laceration rather than a hematoma, while changes in vital signs could be a nonspecific indicator of various complications and not exclusively indicative of a hematoma.
Intense pain would be expected due to the pressure and inflammation caused by a hematoma. Heavy bruising is a visible sign that can be associated with a hematoma due to the accumulation of blood within the tissues. In contrast, while vital sign changes can occur, they might not be as direct a marker of a vulvar hematoma compared to intense pain and visible bruising.