Regarding the dying patient in hospice with nausea during enteral feedings, which statement is true regarding withholding nutrition and hydration?

• A. Intravenous hydration should be used to reduce symptoms of nausea, vomiting, diarrhea and respiratory distress
• B. Dehydration, starvation and ketosis produces a euphoric state that enhances the perception of hunger
• C. The most common symptom when nutrition and hydration are withheld is dry mouth
• D. Electrolyte imbalance should be expected and may produce analgesia

Answer: (C)

When nutrition and hydration are withheld in a dying patient, the focus is on comfort. The most common symptom you’ll see is dry mouth, due to reduced oral moisture as intake is stopped and body fluids shift with the dying process. Addressing this symptom is a core supportive measure: frequent oral care, dampening the mouth with swabs, saliva substitutes if appropriate, humidified air, and lip moisturizers help ease discomfort and thirst even when intake isn’t continued.

The other ideas don’t align with typical hospice practice. Using intravenous fluids to try to lessen nausea, vomiting, diarrhea, or respiratory distress is not routine when nutrition and hydration are withheld, because it can prolong the dying process and may not meaningfully relieve symptoms. Dehydration does not confer a euphoric state, and electrolyte disturbances are not expected to provide analgesia.