medium · NCLEX-RN basic-care
An 88-year-old client with end-stage dementia has been transitioned to comfort care in a hospice facility. The client has stopped swallowing and is refusing all oral intake. The client's daughter is highly distressed and asks the nurse, 'Can we start an IV to give her fluids, or insert a feeding tube? I am terrified that she is going to starve to death.' Which response by the nurse is most clinically accurate and supportive?
- We can insert a temporary nasogastric tube to provide liquid nutrition, which will keep her comfortable and prolong her life.
- At this stage, her body is naturally shutting down, and giving artificial fluids or food can cause fluid overload, painful swelling, and fluid accumulation in her lungs.
- I will contact the provider to get an order for a peripheral IV to infuse normal saline at a slow rate of 50 mL/hour to maintain hydration, as the next nursing response.
- Let's wait another 24 hours, and if she still refuses to eat or drink, we will initiate intravenous nutrition to meet her caloric needs, based on the current findings.
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