The nurse cares for a client who is near death. For which change, indicating that death is imminent, should the nurse observe?
A) Deep breaths with periods of apnea
B) Mottling of upper extremities
C) Skin cool and dusky
D) Signs of respiratory alkalosis
Ans: C
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Physiological changes that occur when death is imminent include gradual hypoxia, respiratory acidosis (not alkalosis), and renal failure. Changes in respiratory patterns (shallow [not deep] breaths with periods of apnea) may indicate significant neurological declines, with Cheyne-Stokes respirations often heralding the impending death. Skin may appear dusky or gray and feel cold or clammy. Mottling of the lower (not upper) extremities may take place days or hours before the actual death.
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