A terminal patient in a skilled nursing home has stated that he does not want to get out of bed, because he is too tired and weak to sit in a chair. He sleeps on and off all day and night, his position is changed every 2 hours, and he is comfortable on his pain regimen. The next day the nurse will:

A. Is no longer grieving the death of his wife: This option makes an assumption about the patient's grief based solely on the choice of words used to describe his wife's passing. The patient's use of a euphemism does not provide enough information to determine the extent of his grieving process.

B. Has a strong religious belief system: While the patient's statement may suggest a belief in an afterlife or reward, it doesn't necessarily indicate the strength of his religious beliefs. Using euphemisms for death is common across various belief systems and cultural backgrounds.

C. Is uncomfortable with the term "death" and is using a euphemism: This is the correct response. The patient's choice of words, "went on to her reward," indicates a discomfort with directly stating "death." Euphemisms like this are often used as a coping mechanism to soften the reality of death or to adhere to cultural or personal preferences.

D. Has dysfunctional grieving and is unable to address his wife's death: There is no evidence in the scenario to suggest dysfunctional grieving. The patient's use of a euphemism does not necessarily indicate an inability to address his wife's death. It may simply reflect individual preferences or cultural norms regarding discussing death.

A. This response aligns with best practices in hospice care, which prioritize comfort and quality of life for terminally ill patients. Dehydration is a common occurrence at the end of life and is generally not associated with discomfort when managed appropriately. IV fluids or tube feedings may cause discomfort, contribute to fluid overload, or lead to complications such as aspiration pneumonia.

B. While the healthcare proxy may have the authority to make decisions on behalf of the patient, the focus should be on honoring the patient's wishes as expressed in advance directives. If the patient has clearly indicated a preference against IV fluids or tube feedings in their advance directives, this should be respected.

C. Encouraging the family to try to talk the patient into accepting IV fluids or tube feedings goes against the principles of patient autonomy and informed decision-making. The decision regarding medical interventions should be based on the patient's preferences and comfort.

D. While dehydration can be uncomfortable in some circumstances, providing adequate symptom management, including pain medication, is essential in hospice care. However, IV fluids or tube feedings are not typically used to manage dehydration in patients who are at the end of life, as they may not improve comfort and can lead to complications.