A terminally ill patient nearing end of life is dehydrated and ...

[jlmhmf]

A terminally ill patient nearing end of life is dehydrated and complains of being thirsty. What can the nurse do to make the patient more comfortable?
 
  1. Provide oral care every 2 hours.
  2. Increase intravenous fluids.
  3. Raise the head of the bed.
  4. Begin enteral feedings.

Question 2

A competent older adult patient has a living will stating that resuscitation and heroic life support measures are to be avoided. The family members are not supportive of this directive. Which action by the nurse is the most appropriate?
 
  1. Place the document on the chart.
  2. Contact the Social Services department.
  3. Notify the hospital attorney.
  4. Explain to the patient that the conflict could invalidate the document.

[beccamahon]

Answer to Question 1

Correct Answer: 1

Dehydration in the patient nearing death causes discomfort primarily from dry mouth and thirst. The patient should be given oral care at least every 2 hours, and more often if the patient is breathing through the mouth. Increasing intravenous fluids could cause peripheral and lung edema. Raising the head of the bed helps with dyspnea, not dehydration. Enteral feedings could cause discomfort and would not help with the discomfort of a dry mouth and thirst.

Answer to Question 2

Correct Answer: 1

The patient is competent, and the wishes of the patient must take priority. The document should first be placed on the chart and the physician notified. If there are concerns about the authenticity of the document, the Social Services department, hospital attorney, or unit supervisor will need to be contacted. A lack of support by the family does not invalidate the document.