NCLEX · Grief, Loss, and End-of-Life

An LPN notices a dying client's breathing has changed to irregular cycles with periods of no breathing followed by rapid deep breaths. What is this breathing pattern called?

Correct answer

Cheyne-Stokes respirations — a pattern of crescendo-decrescendo breathing alternating with periods of apnoea (no breathing); typically seen in the final hours to days of life as cerebral perfusion decreases

  1. A Biot's respirations
  2. B Kussmaul breathing
  3. C Cheyne-Stokes respirations — a pattern of crescendo-decrescendo breathing alternating with periods of apnoea (no breathing); typically seen in the final hours to days of life as cerebral perfusion decreases
  4. D Ataxic breathing

Why this is the answer

Cheyne-stokes respirations: Pattern: gradually increasing then decreasing depth of breathing, followed by a period of apnoea (10-60 seconds), then the cycle repeats.

Cause: Progressive decrease in cerebral perfusion and CO2 sensitivity as death approaches; CO2 builds during apnoea, triggering a burst of breathing until CO2 is cleared, then apnoea again.

Clinical significance: Normal finding at end of life — not a sign of distress or need for emergency intervention.

Family education: Families are often frightened by Cheyne-Stokes — explain that this is a normal part of the dying process, is not painful or distressing to the patient, and indicates the person is entering the final stage.

Compare: Kussmaul = deep rapid breathing (metabolic acidosis); Biot's = irregular varying depth with apnoea (brainstem damage); Ataxic = completely irregular (severe brainstem damage).

Source: NCLEX-PN PS — End of Life, Cheyne-Stokes Breathing

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About this topic: Grief, Loss, and End-of-Life

Grief, loss and end-of-life questions cover stages and types of grief, supporting a dying client and family, comfort care, advance directives and the nurse's own responses to loss. This is one of 13 PN: Psychosocial Integrity questions on grief, loss, and end-of-life, each with a full explanation on a single study page.

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