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October 2004, Volume 34 Number 10 , p 10 - 10





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    I'm a private-duty nurse working in patients' homes. Several of my patients who are terminally ill don't want to eat or even drink very much. Should I be encouraging them to drink more to prevent them from becoming dehydrated? —J.K., R.I.

    Offer a terminally ill patient her favorite fluids, but don't force her to drink. As the body slowly shuts down, it simply can't tolerate much more than small quantities of liquids. Intravenous fluids would add to the burden, resulting in fluid overload and pulmonary edema, which can give the dying person a frightening sensation of drowning.

    Figure. No caption available. Even when fluid intake is minimal, you may see signs of fluid accumulation and hear what was once called the “death rattle.” This sound can be quite disconcerting to family members sitting by the patient for long hours, so I administer hyoscyamine sulfate (Levsin) to dry up secretions ...

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