Which of the following is NOT a sign of compensated shock in the infant or child?

• A. Tachycardia
• B. Cool skin
• C. Abnormal mentation
• D. Delayed capillary refill

Answer: (C)

During compensated shock in children, the body preserves blood flow to vital organs by activating the sympathetic nervous system. This produces a rapid heart rate to maintain cardiac output and peripheral vasoconstriction, which leads to cool, clammy skin and delayed capillary refill. Blood pressure can still be normal at this stage, because the cardiovascular system is compensating.

Abnormal mentation, such as confusion or lethargy, tends to appear when perfusion worsens and the child moves from compensation to decompensation. At that point the brain is not getting enough blood flow, and mental status changes become more evident. So the sign that does not fit compensated shock is abnormal mentation.