Physical Manifestations at End of Life

Physical Manifestations at End of Life 150 150 Tony Guo

Physical Manifestations at End of Life

  • Metabolism is decreased
  • Body gradually slows down until all function ends
  • Respiration generally ceases first
    • Heart stops beating within a few minutes
  • Respiratory System
    • Cheyne-Stokes respiration (pattern of breathing characterized by alternating periods of apnea and deep, rapid breathing.)
    • Inability to cough or clear secretions
      • Grunting, gurgling, or noisy congested breathing (“death rattle”)
    • Irregular breathing that gradually slows down to terminal gasps
  • Sensory System- Hearing and Touch
    • Hearing is usually last sense to disappear
    • Decreased sensation
    • Decreased perception of pain and touch
  • Sensory System – Taste, Smell, and Sight
    • Blurring of vision
    • Blink reflex absent
    • Patient appears to stare
    • Eyelids remain half-open
    • Decreased sense of taste and smell
  • Integumentary System
    • Mottling on hands, feet, arms, and legs
    • Cold, clammy skin
    • Cyanosis of nose, nail beds, knees
    • “Wax-like” skin when very near death
  • Urinary System
    • Gradual decrease in urinary output
    • Incontinent of urine
    • Unable to urinate
  • Gastrointestinal System
    • Slowing of digestive tract and possible cessation of function
    • Accumulation of gas
    • Distention and nausea
    • Loss of sphincter control
    • Bowel movement may occur before imminent death or at the time of death
  • Musculoskeletal System
    • Gradual loss of ability to move
      • Trouble holding body posture and alignment
    • Loss of facial muscle tone
      • Sagging of jaw
      • Difficulty speaking
      • Loss of gag reflex
      • Swallowing can become more difficult
  • Cardiovascular System
    • Increased heart rate; Later slowing and weakening of pulse
    • Irregular rhythm
    • Decreased BP
    • Delayed absorption of IM or SQ drugs

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