A child in compensated shock will show which symptoms?
A.
Somnolence, hypotension, oliguria
B.
Irritability, tachypnea, hypotension
C.
Irritability, capillary refill time > 2 seconds, bradycardia
D.
Irritability, tachycardia, poor peripheral perfusion
The Correct Answer and Explanation is:
Correct Answer: D. Irritability, tachycardia, poor peripheral perfusion
Explanation:
Compensated shock is an early stage of shock where the body can still maintain adequate blood pressure and perfusion to vital organs despite a significant reduction in circulating blood volume. This is achieved through various compensatory mechanisms, such as increased heart rate, vasoconstriction, and fluid retention.
In children, compensated shock can be difficult to recognize because they have a greater capacity to maintain blood pressure compared to adults. However, subtle signs can indicate the body’s attempt to compensate for reduced perfusion.
Key Signs of Compensated Shock in Children:
- Irritability: A child in compensated shock may become irritable or anxious due to decreased oxygen delivery to the brain. Irritability is often an early sign that the body is under stress and trying to maintain adequate perfusion.
- Tachycardia: The heart rate increases as the body attempts to maintain cardiac output despite decreased circulating volume. Tachycardia is a primary compensatory mechanism to ensure that enough blood reaches vital organs.
- Poor Peripheral Perfusion: Vasoconstriction, which is the narrowing of blood vessels, occurs to redirect blood flow to essential organs such as the heart and brain. This can lead to cool, clammy skin and delayed capillary refill time (CRT). A CRT of more than 2 seconds is indicative of poor peripheral perfusion, a key sign of shock.
Why the Other Options Are Incorrect:
- Option A (Somnolence, hypotension, oliguria) describes symptoms more consistent with decompensated shock, a more advanced and severe stage where the body can no longer maintain adequate blood pressure and perfusion. Somnolence (drowsiness), hypotension (low blood pressure), and oliguria (reduced urine output) indicate that the compensatory mechanisms have failed.
- Option B (Irritability, tachypnea, hypotension) includes hypotension, which is again a sign of decompensated shock. While irritability and tachypnea (increased respiratory rate) can be seen in compensated shock, hypotension indicates that the body’s compensatory mechanisms are failing.
- Option C (Irritability, capillary refill time > 2 seconds, bradycardia) includes bradycardia (slow heart rate), which is not characteristic of compensated shock. Bradycardia usually occurs in a very late stage of shock when the body is no longer able to compensate, indicating impending cardiovascular collapse.
In summary, option D correctly identifies the symptoms of a child in compensated shock. Recognizing these early signs is crucial for timely intervention and preventing the progression to decompensated shock, which carries a higher risk of mortality.