The nurse is caring for a terminally ill patient who is actively dying and refuses to eat anything other than a few bites of ice cream

Question

The patient's family member approaches the nurse and requests that a feeding tube be inserted so that her loved one will not starve to death. What is the best response of the nurse?
a.
"Loss of appetite is a natural part of the dying process. Tube feedings would be uncomfortable and cause nausea."
b.
"I will contact the physician to obtain an order to insert the tube and start tube feedings."
c.
"Intravenous fluids would be more comfortable for the patient than a tube feeding. I will call the doctor to get the order."
d.
"I will listen to the patient's abdomen to make sure that bowel sounds are present and try encouraging oral fluids."

Answer 1

ANS: A
Loss of appetite and decreased oral intake is expected during the last stages before death as the gastrointestinal tract shuts down. Encouraging oral intake will lead to increased secretions and congestion as well as possible aspiration of fluids. Intravenous fluids will increase congestion and edema. Tube feedings will cause discomfort as the tube is inserted and nausea as the GI tract is given food that it cannot handle.