Emotional SupportQuestion 153 of 200

Which observation is a sign of the active dying phase?

a.Mottling (bluish-purple skin discoloration) of the lower extremities, cool extremities, decreased urine output, and decreased level of consciousness
b.Increased appetite and weight gain
c.Strong, regular pulse and elevated blood pressure
d.Returning to baseline cognition and ambulation

Explanation

Active dying signs include mottling (livedo reticularis from poor perfusion) starting in feet and progressing upward, cool/cyanotic extremities, decreased urine output, decreased LOC, Cheyne-Stokes respirations, 'death rattle' (oral secretions), and sometimes terminal restlessness. These are expected and the CNA's role is comfort care: repositioning gently, mouth care for dryness, clean linens, calm environment, and family presence. Improving signs (b, c, d) are not features of active dying. 42 CFR §483.25(k) addresses end-of-life care.

Law Reference: 42 CFR §483.25(k)

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