Pain Management

Symptom Management
Common Symptoms:
Bowel Management
Nausea and Vomiting
Terminal Phase
Changing Awareness
Altered Elimination
Respiratory Changes
Agitation or Restlessness
Signs of Impending Death
Caregiver Support

The Terminal Phase of Illness

Although the signs and symptoms of imminent death vary in frequency and occurrence with each patient, the dying process itself is similar regardless of the diagnosis. Hypoxia, hepatic and renal failure, malnutrition, fluid and electrolyte imbalances, and tumor burden in cancer patients exhaust the body’s capability to maintain homeostasis, and death occurs (Hospice and Palliative Nurses Association Core Curriculum, 2002).

Comfort remains the first goal in the plan of care at the end of life. Dignity and privacy for the patient and caregivers, as well as education as to what they can expect in the last days and hours of the illness are also important goals. To meet this challenge, the nurse must also know what symptoms to expect in the terminal phase of illness and how to manage them. The most common symptoms to prepare for are respiratory changes, pain, elimination, agitation/restlessness, and awareness.