Body fluids and death

[kbswife]

I wanted to know if it is true that when a person dies do all of their body fluids release? ie: urine, feces, blood??? And also, how did you cope the first time a pt. died?

[ericalynn, BSN, RN]

Here's my experiences with patients dying. Again these are just MY experiences, I have only been a RN for 9 months and only come across aprox. 7 deaths. Yes they do lose body fluids, however, most of them have foley's in, and most have not really eaten anything in the past few days. Typically when a person dies (not suddenly) their urine output has already decreased to next to nothing, so there is not much urine to deal with and there is some feces, but usually not much. As far as blood goes I am not sure where it is going to "release" from, so no I haven't seen alot of blood.

The first time I had a patient die and I had to pronounce them I was really nervous that they weren't actually dead! I had to make 5 other nurses plus the charge and house supervisor check!!

I think your feelings on each death you deal with will be different, you get to know certain patients in different ways, and some jsut come to you at the end of their lives so you don't really get a chance to know them much at all. I always feel sad, and say a little prayer for them but I am confident in knowing that I did everything I could to help them make a safe and peaceful transition to that "next place":redpinkhe

[leslie :-D]

Especially feces, urine.

I have seen bleeding from orifices too, but not as frequently.

It all depends on pt's pathology, that may cause s/p bleeds.

I'm very good with death.

But this revolves around my personal beliefs.

Often it's a blessing.

If you are upset witnessing your first death, you are certainly not alone.

We live in a society that views death as a necessary evil.

You are perfectly normal if you need to cry.

It is upsetting to many.

Your 2nd death will be slightly easier...not to say it ever gets 'easy'.

But you will find your own unique coping mechanisms.

Gentle hugs to you...

Leslie

[NICU_babyRN, BSN, RN]

I worked as a CNA for 19 months in palliative care nursing and probably cared for at least 3-4 actively dying patients each week. Yes, they may release urine and feces but it is usually not a lot as they posters above stated. If a person is dying of internal injuries you may see some blood too. Lung hemorrhages may result in blood in the ET tube, mouth, nose, but you wont see things that you see in movies with blood everywhere.

Although death is hard, many times it is a blessing and an end to much suffering not only for the person dying but also the family. I was glad not to work in palliative care anymore, and I'm really glad I went from 3-4 deaths each week at work to a total of 12 in 12 months as a NICU RN.

[Valerie Salva, BSN, RN]

There is usually a little feces, urine, and sometimes blood when a pt dies. No big deal, you just clean the pt as part of post mortum care.

I remember one time, I was standing with the water running, absentmindedly waiting for it to get warm. My co-worker reminded me that in this instance, the pt would not mind if the water was cold. lol @ me.

Live pts are far messier.

As far as coping, it really depends on the circumstances of the pt's death, and what kind of nursing you are doing.

Sometimes death is a blessing, other times, it's a tragedy.

If you are in school, you will study death and dying, and learn about post mortum care. When you go to work, you will learn by observing your co-workers and communicating with them.

[jessiern, BSN, RN]

It all depends on the patient. Most patients I have seen die did pass stool, but mostly just a "smear", and if they didn't have a foley during or shortly after death the urine is passed.

I did witness one death early on as a tech that was very disturbing for me personally. I don't remember all the details, because its been years ago, and I didn't know a lot about disease patho at the time. I do remember that she dying from liver disease mainly, and have other system failures. What I do remember vividly is that the patient was leaking green bile from her eyes, ears, and other orifices an hour before, and after her death. A nursing instructor told me that was not possible, but I know what I remember, and the nurses that were there remember it too.

[Transplant Nurse, BSN, RN]

I have seen lots of deaths after terminal weans (100+), and many more post-mortem within 12 hours of cardiac death for tissue recovery when family chose for them to become a donor. These patients did not have cancer, or a chronic process (except heart problems, renal failure, and acute hepatic failure some in DIC). The only secretions I saw were a complete emptying of the bladder with release of urine and small slow release of stool because of loss of sphincter control. So as you moved them and gasses build up there is a small release of stool, after 12 hours post-mortem there is a lot of gas which is terribly offensive odor wise and some more stool will be released with this. The patients with DIC had small amounts of bleeding from the ears and nose. Of course with DIC you can have blood from any orifice (eyes, in urine, in stool etc). That is my take.

[Aintboverd]

Hi there I'm a C.S.W. working in a gastroenterology ward. Just the other day we had an alderly gentleman that sadly passed away. (Thoughts are with his family) In this instance when preparing the body there were a few things different. First of all the smell that emitted from his mouth. I washed the patient and shaved him making sure he was presentable for the family members to vist. When I turned him on his side the most foul smell I have had the misfortune to smell came from his mouth, that and 2 liters of brown liquid I can only define as mixed bodily fluid of blood, urine, feaces, stomach acid ( you name it it was there) This has only happened once in in the past 16 moths. I believe the gentleman had final stage cirrhosis of the liver.

Hope this helps.

[casi, ASN, RN]

Body fluids depend on the person and the death. Most deaths there is a release of urine and a release of bowel. If it's someone you pulled IVs out of post-mortem you may seem some blood seeping from those as well.

The worse I saw was as an aide in ICU. They think she had dead bowel and DIC (which causes copious amounts of bleeding) Once we were done coding her she was covered in blood and a mixture of gastric contents, stool, dead bowel stuff. When we turned her blood came pouring out of her breathing tube and bowel came seeping out of her nose and mouth. It was horrifying to see. What made the task of trying to clean her up okay for me was that I knew her family would be in to see her. Her death was very sudden and traumatic and I wanted to leave them with some half decent memories.

For me post-mortem ccare is the last really nice thing you can do for a patient and their family.

[Daisy_08, BSN, RN]

The very first dead body I did PM care for I was in first year of nursing school. I had not seen the pt alive so it did not really bother me, however she really "leaked". I can't remember what her illness was, but I believe she was not happy with quality of life and stopped eating and drinking, COD was dehydration. She had large amounts (*graphic alert*) very foul blood/mucous coming from her lady parts and orifice. We tried to clean her up but we had to put two inc. pads on her and just send her like that.

I then went on to consolidate in Palliative care. My first death there was difficult. We knew the pt would die that day, and called the family, but they did not want to come in so I was with the pt. He was not in pain, but agitated, still making sense and talking. I left the room for something to calm him down and came back in and he had passed. I didn't cry but felt like I could have. When I was doing PM care I kept thinking he move or something (too many horror movies )

But I never saw anyone else release all of their fluids like that first death I saw.

[JBudd, MSN]

I once warned a new grad with her first body, that the body makes noise when turned as gasses escape. She didn't believe us at first, but when we turned him on his side to put the shroud under him there was a loud groan. That always gets to me more than the fluids (we clean those up living or dead).

[diva rn, BSN, RN]

I worked at an Inpatient Hospice facility (which was like a luxury hotel and beautiful) and I loved the job.

Obviously I saw many, many deaths and took and active part in making the patient comfortable and dignified in their last weeks/days/hours... they had all accepted death as part of life and the next logical step in the progression-most of the patients would go with their families, friends and other loved ones surrounding them...it was wonderful and very gratifying---

-in contrast to that, I also worked in ICU and saw many deaths there...it seems like the type and amount of body fluids have to do with the conditions under which the death took place. I have seen deaths where there were virtually no fluids..mainly in babies (I also worked PICU-and any death there is not a good death)..and also COPIOUS fluids---like from the aforementioned bleeding esophageal varices....where the blood was gushing literally out of his mouth and orifice and pooling on the floor.

So, it's kind of different in every death.

By the way--if you want something different--try hospice nursing...I really loved it!