Which of the following best indicates hemodynamic instability?

• A. Normal blood pressure and pulse
• B. Warm extremities and capillary refill under 2 seconds
• C. Hypotension with tachycardia and cool extremities
• D. Adequate urine output

Answer: (C)

Hemodynamic instability shows poor tissue perfusion with the body trying to compensate. When perfusion drops, the heart rate typically rises to keep cardiac output, and the peripheral vessels constrict, making the extremities feel cool. Low blood pressure reflects reduced driving pressure for organs, and the combination of hypotension, tachycardia, and cool extremities signals ongoing instability that needs prompt assessment and intervention. In contrast, normal blood pressure and pulse, or warm extremities with quick capillary refill and adequate urine output, indicate adequate perfusion and stability.