A dying patient with malignant bowel obstruction has distressing thirst and fluctuating delirium despite meticulous mouth care; oral intake is

Question

A dying patient with malignant bowel obstruction has distressing thirst and fluctuating delirium despite meticulous mouth care; oral intake is unsafe. There is no pulmonary oedema. What is the most appropriate discussion about clinically assisted hydration?

Accepted Answer

Offer a 12-hourly reviewed trial and continue it for benefit or reduce it for harm

Answer

Start one litre intravenously every 24 hours and continue until death if serum sodium improves

Answer

Avoid parenteral fluid throughout the dying phase and manage all dehydration-related symptoms with mouth care

Answer

Use nasogastric water at a fixed rate and judge benefit from urine output after 72 hours

Answer

Give subcutaneous fluid only after the family accepts that it may prolong the dying process

End of Life Hydration — SCE Medical Oncology MCQ

A dying patient with malignant bowel obstruction has distressing thirst and fluctuating delirium despite meticulous mouth care; oral intake is unsafe. There is no pulmonary oedema. What is the most appropriate discussion about clinically assisted hydration?