مريض بعد عملية في البطن، مراقبة كل ساعة. أي نمط يدل على بداية صدمة نقص الحجم؟

A post-abdominal-surgery client has hourly observations. Which pattern suggests early hypovolaemic shock?

1. A systolic BP below 80 mmHg
2. No urine output for 4 hours
3. Rising pulse with narrowing pulse pressure
4. Fixed, dilated pupils

Answer: C) Rising pulse with narrowing pulse pressure. Early on the body compensates with tachycardia and vasoconstriction, so the pulse rises and the pulse pressure narrows, often with restlessness. Systolic below 80 and anuria are late signs, and fixed pupils are very late.