When treating an 80-year-old patient who is in shock, it is important to remember that:

• A. Medications older patients take for hypertension often cause an unusually fast heart rate.
• B. Compensation from the respiratory system usually manifests with increased tidal volume.
• C. Older patients’ central nervous system usually reacts more briskly to compensate for shock.
• D. Changes in gastric motility may delay gastric emptying, which increases the risk for vomiting

Answer: (D)

In older adults, age-related changes in the gastrointestinal system can slow gastric emptying. When an elderly patient is in shock, this delayed gastric motility is more likely to lead to vomiting, and with the patient possibly being perimorbid or undergoing airway management, the risk of aspiration increases. This makes recognizing and mitigating GI symptoms a priority: secure the airway promptly when vomiting is a risk, prefer IV medications to avoid relying on the stomach, and have antiemetic options ready.

Other statements assume responses that aren’t reliably present in older patients. Medications used for hypertension don’t universally cause a fast heart rate, and the cardiovascular response to shock can be blunted by age or chronic meds. The respiratory system’s compensation isn’t guaranteed to present as a straightforward increase in tidal volume, since lung function and chest wall mechanics in older adults can limit that response. The central nervous system’s compensatory reaction to shock is not typically brisk in the elderly, who often show diminished autonomic reserve.