A family member is concerned that a patient near the end of life is not eating or drinking and asks the nurse how the family can help the patient increase oral intake. Which response by the nurse is most appropriate?
a. "The best way to feed the patient is with a syringe and small amounts of water or liquid feeding."
b. "The less the patient drinks, the less urination will be necessary and urination can be uncomfortable at this point in the dying process."
c. "The starvation process at the end of life is quite natural; a side benefit is that lower doses of medications are needed to keep the patient comfortable."
d. "As your family member becomes dehydrated from not eating or drinking, natural endorphins will be released, which increase comfort near the end of life."
ANS: D
Benefits in withholding artificial feeding and hydration in the final weeks of life in actively dying patients include fewer pharyngeal and lung secretions, which can reduce dyspnea; reduced swelling around tumors, which can reduce associated pain; and less urination, resulting in dryer skin with fewer breakdowns. It has also been theorized that as dehydration occurs, the body produces a form of endorphin, which enhances comfort. A. Feeding may not be the best action. B. Urination is not uncomfortable. C. Use of the word starvation may be distressing to the family.
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