What late sign of shock may indicate significant distress?

Thirst is a late sign of shock that can indicate significant distress in the body. When a person is experiencing shock, their body begins to prioritize vital organ function and, as a result, may divert blood flow away from less critical areas, leading to reduced kidney perfusion. This decreased blood flow can result in dehydration and subsequent thirst as the body attempts to regain fluid balance. Increased thirst suggests that the body's mechanisms are responding to a deficiency in blood volume or fluid status, which aligns with the pathological processes occurring during shock.

In contrast, the other options do not indicate significant distress associated with shock. Increased urine output usually suggests adequate blood flow to the kidneys, which contradicts the state of shock. Clear skin indicates good perfusion and hydration rather than a state of distress. Elevated blood pressure can sometimes occur in the early stages of shock; however, it often drops later as shock progresses, making this an unreliable indicator of significant distress. Thus, thirst stands out as a clear signal of the body's struggle to maintain homeostasis under severe stress.