A man believed to be in the last days of life has distressing thirst and fluctuating delirium despite frequent mouth care and assisted sips. He has

Question

A man believed to be in the last days of life has distressing thirst and fluctuating delirium despite frequent mouth care and assisted sips. He has no pulmonary congestion and requests a trial of fluids. What is the most appropriate next step?

Accepted Answer

Trial clinically assisted hydration with 12-hourly review for symptomatic benefit and fluid-related harm

Answer

Give a fixed two-litre daily intravenous prescription without reassessing thirst, delirium or respiratory status

Answer

Use serum sodium alone to determine whether clinically assisted hydration should be started and continued

Answer

Withhold all clinically assisted hydration because it invariably prolongs the dying process without symptom benefit

Answer

Start clinically assisted hydration and maintain the prescription if pulmonary secretions or oedema subsequently develop

Recognition of Palliative Medicine Specialty — SCE Palliative Medicine MCQ

A man believed to be in the last days of life has distressing thirst and fluctuating delirium despite frequent mouth care and assisted sips. He has no pulmonary congestion and requests a trial of fluids. What is the most appropriate next step?