A nurse finds that a terminally ill patient has cold, clammy, and wax-like skin. What should the nurse infer from this assessment?

• A. The patient is improving.
• B. The patient is likely to die soon.
• C. The patient has edema and needs diuretics.
• D. The intravenous fluids have extravasated.

Answer: (B)

In the dying process, the body’s circulation slowing and failing to meet tissue needs shows up in the skin. Cold, clammy, wax-like skin means peripheral perfusion is markedly reduced as life nears its end. This is a sign that death is imminent rather than reversals or new problems developing. It reflects how the body prioritizes core organ function and reduces blood flow to the skin.

So, this assessment indicates the patient is likely to die soon, not that they are improving. It isn’t a sign of edema needing diuretics, and it doesn’t suggest IV fluids have extravasated. The appropriate response is to continue comfort-focused care, keep the patient warm, and support the family.