In decompensated shock, what happens to the patient’s blood pressure?

• A. Heart rate continues to increase
• B. Blood pressure starts to fall
• C. Pulmonary edema improves
• D. Skin becomes warm and dry

Answer: (B)

In decompensated shock, perfusion can no longer be maintained, so arterial pressure falls. The rise in heart rate and peripheral vasoconstriction that helped compensate can no longer sustain blood pressure, and mean arterial pressure drops, leading to hypotension. Tachycardia may still be present, but it no longer prevents the fall in pressure. The skin is typically cold and clammy due to reduced peripheral perfusion, not warm and dry. Pulmonary edema isn’t a guaranteed improvement at this stage and can worsen if the heart’s pumping ability is compromised. So the defining change is that blood pressure starts to fall.