The nurse is caring for an 87-year-old client who is admitted with manifestations of shock. Which of the following findings would the nurse identify as characteristics of older adults with shock? Select all that apply

A. Fatigue without a fever is correct because older adults often have a blunted immune and inflammatory response. They may not develop a fever even in severe infection or septic shock. Instead, they commonly present with nonspecific symptoms such as weakness, fatigue, or malaise. B. Weakened respirations is correct because aging is associated with decreased lung elasticity, reduced chest wall expansion, and weaker respiratory muscles. In shock, older adults may not mount a strong tachypneic response and can demonstrate shallow or weakened respirations. C. Normal sinus rhythm is incorrect because shock typically triggers compensatory tachycardia. However, in older adults, especially those taking medications such as beta blockers, the heart rate response may be blunted. A completely normal sinus rhythm is not considered a characteristic finding of shock; altered or inadequate compensatory responses are more typical. D. Decreased clarity of thinking is correct because altered mental status is often one of the earliest and most significant signs of shock in older adults. Reduced cerebral perfusion leads to confusion, restlessness, agitation, or lethargy. E. Adequate urinary output is incorrect because shock results in decreased renal perfusion, leading to reduced urinary output (oliguria). Adequate urine output would not be expected in a client experiencing shock.