A patient with esophageal varices is at risk for hemorrhagic shock. Which sign indicates hypovolemia?

• A. Hyperhidrosis
• B. Tachypnea
• C. Hypotension
• D. Fever

Answer: (C)

When blood loss from a variceal bleed reduces intravascular volume, venous return and cardiac output fall. If enough volume is lost that the arterial pressure can’t be maintained, the result is hypotension, which directly signals hypovolemia and compromised perfusion. Other signs listed aren’t specific to low blood volume—excess sweating can occur with stress, fever points to infection, and tachypnea can be a compensatory response but isn’t a definitive indicator of hypovolemia on its own. In hypovolemic states, a fall in blood pressure is the key sign that volume depletion is severe enough to threaten perfusion.