Which sign is observed in the circulation domain during pediatric hypovolemic shock?

• A. Tachycardia with narrowed pulse pressure
• B. Bradycardia
• C. Normal capillary refill
• D. Bounding pulses and warm skin

Answer: (C)

In pediatric hypovolemic shock, the circulation domain is driven by reduced preload from blood loss, so the body compensates by increasing heart rate to maintain cardiac output while vasoconstriction narrows the pulse pressure. This rapid pulse with a relatively small difference between systolic and diastolic pressures reflects the heart trying to push what little volume is left and preserve blood pressure. Perfusion to extremities drops, so capillary refill becomes delayed and the skin often feels cool and pale. Bradycardia signals worsening decompensation, and bounding, warm pulses point more toward distributive shock rather than hypovolemia. So the sign aligned with this circulation picture is a fast heart rate with a narrowed pulse pressure, with delayed capillary refill as perfusion declines.