Which sign is commonly overlooked early in shock?

• A. Hypotension
• B. Bradycardia
• C. Tachycardia
• D. Cool skin

Answer: (C)

Early in shock the body tries to preserve perfusion by increasing the heart rate. This rapid pulse is an early compensatory change because raising the heart rate helps maintain cardiac output as other parts of the system start to falter. It’s easy to miss because blood pressure can remain near normal in the early stages, and a fast heartbeat is often attributed to anxiety, pain, or recent activity rather than evolving shock. Other signs, like hypotension or cool, clammy skin, tend to appear later, so focusing only on blood pressure can delay recognition of shock. Keep in mind that in some people—such as older adults or those on beta blockers—tachycardia may be blunted, but in typical early shock, tachycardia is the first signal clinicians should notice.