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Difficulty: EasyPhysiological Adaptation

A client is recovering in the surgical unit after an open abdominal procedure. Which assessment finding provides the earliest physiological indication that the client is developing hypovolemic shock?

  1. A gradual increase in the resting heart rateAnswer
  2. B
    A significant decrease in systolic blood pressure
  3. C
    A reduction in hourly urine output to less than 20 mL
  4. D
    A development of cold, clammy, and mottled extremities

Answer

A gradual increase in the resting heart rate
An increase in resting heart rate is one of the earliest compensatory mechanisms triggered by the sympathetic nervous system. It attempts to maintain adequate cardiac output and tissue perfusion as intravascular fluid volume begins to decrease.

Step-by-Step Solution

1
Recall the physiological progression of shock.
The body first activates compensatory mechanisms, primarily the sympathetic nervous system, to maintain tissue perfusion.
Understanding the timeline of physiological responses is necessary to identify the earliest clinical signs.
2
Evaluate the clinical findings against the stages of shock.
Tachycardia occurs in the early compensatory stage, while hypotension and mottling occur in the progressive or irreversible stages.
This differentiates early, subtle indicators from obvious, late decompensation.

Key Concept

Early recognition of hypovolemic shock
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Topics

Physiological Adaptation

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