Terminal sign of irreversible hypovolemic shock?

• A. Tachycardia
• B. Bradycardia
• C. Hypertension
• D. Irregular pulse

Answer: (B)

In hypovolemic shock, the body first tries to compensate for low circulating volume by increasing the heart rate to maintain perfusion. When the situation becomes irreversible, severe tissue hypoxia and metabolic acidosis depress the heart and blunt sympathetic drive, so the heart cannot sustain a fast rate. The result is a slowing of the pulse—bradycardia—which signals that the patient is nearing cardiac arrest despite fluid loss. Hypertension is not typical in hypovolemic shock, and tachycardia or an irregular pulse are more characteristic of earlier or different stages or conditions, so the terminal sign is the slow heart rate.