In terminally ill patients, which statement about electrolyte values during dehydration and the use of ANH is supported by evidence?

• A. Electrolyte values are typically highly abnormal in terminally ill patients receiving ANH.
• B. Electrolyte values in dying patients are often within the normal range.
• C. Artificial nutrition and hydration guarantees a comfortable death.
• D. Hydration eliminates endorphin production.

Answer: (B)

In terminal illness, electrolyte balance can remain surprisingly stable even when a patient is dehydrated. The best-supported finding is that dying patients often have electrolyte values within the normal range. Although dehydration can occur, the body's regulatory mechanisms and changes in intake often keep sodium, potassium, chloride, and bicarbonate within reference limits until late in the course, so abnormal electrolytes are not as predictable as one might assume.

This is why the statement about electrolytes being often normal is the strongest, evidence-based point. The idea that artificial nutrition and hydration will guarantee a comfortable death isn’t supported by consistent evidence, since comfort depends on many factors and ANH can have risks or may not improve symptoms. Hydration also does not eliminate endorphin production; endorphins are part of the body’s endogenous pain modulation and aren’t removed simply by fluids.