Normal End of Life Physiological Changes
What happens to energy levels as someone nears EOL?
Progressive weakness and fatigue increase; more time spent sleeping.
How often should full vital signs be taken at EOL?
They are usually unnecessary unless the family specifically requests.
What is a core guiding belief or EOL care?
There is always something we can do for comfort.
What is the first step when notifying family about a death by phone?
Confirm who you are speaking with.
What is the first step in pronouncing death?
Check respirations for one full minute.
Why might patients refuse visitors at EOL?
What should you do before touching or turning the patient?
Explain what you are doing to both patient and family.
What must nurses anticipate?
Changes in condition and evolving needs.
What should you ask before delivering bad news over the phone?
Whether they are alone and what they understand about the situation.
What is the second requirement for confirming death?
No apical pulse for one full minute.
What causes mottling of the lower limbs?
Decreased perfusion as circulation slows.
What might agitation or movement indicate?
Possible pain or discomfort.
Why is communication essential?
It guides family expectations and reduces fear.
What phrase is recommended when informing family of death?
"I'm afraid I have some bad news."
What pupil finding is consistent with death?
Fixed and dilated pupils.
How do respiratory patterns typically change?
Periods of apnea, shallow breaths, Cheyne-Stokes breathing.
What pulse assessment is commonly used during active dying?
Radial pulse for rate and quality (weak/thready).
What kind of support should nurses intentionally offer families?
Emotional, informational, and practical support.
What is important to provide after giving bad news?
Clear instructions on where to go and whom to contact.
Name one component of post-death body care.
Bathe the body, clean gown, align body, place dentures, comb hair.
Why is urinary output reduced at EOL?
Low blood pressure and reduced renal perfusion.
What does the presence of mottling often signal?
Death is approaching very soon.
Why is understanding the illness trajectory important?
It ensures symptoms are recognized early and managed appropriately.
What is key when supporting family after death?
Allowing space for emotional reaction and time to say goodbye.
Why is returning belongings and valuables important?
It provides closure for the family and must be documented.