In end-of-life bowel obstruction, parenteral nutrition (PN) is described as:

• A. May be appropriate for long-term, but not well tolerated and may increase distress, sepsis risk, GI suction, and fluid overload
• B. Always preferred due to better hydration
• C. Has no impact on distress or sepsis
• D. Contraindicated in all cases

Answer: (A)

In end-of-life bowel obstruction, decisions about nutrition support hinge on weighing potential benefit against the burdens and risks of treatment. Parenteral nutrition can provide calories and nutrients when the gut cannot absorb, but it does not fix the obstruction and requires a central venous line with its own complications. It may be considered if there is a realistic possibility of longer-term benefit or gut recovery, but it brings substantial downsides. The burdens include patient distress from invasive IV access and monitoring, an increased risk of catheter-related infections (sepsis), and potential fluid-related problems like overload. It can also complicate symptom management if ongoing IV therapy interferes with comfort-focused goals. For patients whose priority is quality of life and symptom relief in the near term, PN is often not favored, whereas in some longer-term scenarios it might be appropriate despite these risks.