2025-08-06·7 min read·Category Guides
End-of-Life Nursing Care for the NCLEX
Palliative care, hospice, advance directives, and comfort measures for the NCLEX-RN.
Palliative vs Hospice Care
- Palliative: Comfort care alongside curative treatment - available at any stage of illness
- Hospice: Comfort care when prognosis is ≤6 months and curative treatment is discontinued
Advance Directives
- Living will: Written document stating treatment preferences
- Durable power of attorney for healthcare: Designates a healthcare proxy
- DNR/DNAR: No resuscitation if cardiac/respiratory arrest
- The client can revoke advance directives at any time, verbally or in writing
Signs of Approaching Death
- Cheyne-Stokes respirations (alternating deep and shallow breathing with apnea)
- Death rattle (secretions in throat)
- Cool, mottled extremities
- Decreased urine output
- Withdrawal, decreased consciousness
Nursing Priorities
- Pain management is the priority - do not withhold opioids for fear of hastening death
- Maintain dignity and comfort
- Support the family - grief counseling, spiritual care
- Hearing is the last sense to go - speak calmly, assume the client can hear
Review our Psychosocial study guide and Grief & Loss deep dive.