What are the physical signs and symptoms of approaching death? select all that apply.
Important note: This is a general overview of some of the symptoms dying persons may experience at the end of life. Individual experiences are influenced by many factors, including the person’s illness(es) and medications, but there are some physical changes that are common. Show For some people, the dying process may last weeks; for others, it may last a few days or hours. As death approaches, you may notice some of the changes listed below. Activity level decreases significantly
Interest in surroundings fades
Desire for food and drink ceases
Bowel and bladder changesConstipation may become more evident, requiring increased use of stool softeners or laxatives to maintain comfort, although these medications should be discontinued if the person has had little to no intake of food or fluid for several days. Loss of bladder control and functioning can also occur. If incontinence increases discomfort because of breakdown of skin, or if your healthcare provider suspects urine is being retained in the bladder for any reason, a foley catheter may be recommended. A foley catheter is painless when in place and will help to protect the surrounding skin, provide possible relief from abdominal pain/pressure resulting from urinary retention, and minimize the burden of turning and repositioning during diaper or pad changes. Body temperature can decrease by a degree or more
Blood pressure, heart rate, and respiration (breathing) rates gradually decrease
Increases in pain due to progression of disease, worsening of chronic conditions such as arthritis or stiff/inflamed joints, or increase in pressure wounds to skinWhile some people will be able to verbally indicate that they are in pain, for non-verbal people, pain or distress may be evident from signs such as moaning/groaning, resisting movement by stiffening body, grimacing, clenching of fists or teeth, yelling, calling out, agitation, restlessness, or other demonstrations of discomfort. Hospice and palliative care providers are able to prescribe medications in liquid form that are absorbed sublingually (under the tongue or inside of the cheek and absorbed through the mouth) to provide rapid symptom relief. Skin of the knees, feet, and hands may become purplish, pale, grey, and blotchy or mottledThese changes usually signal that death will occur within days to hours. Pressure wounds can be chronic and develop at any stage of terminal illness, particularly if the person becomes very debilitated and is bedbound for a significant amount of time or they experience significant loss of weight or muscle wasting as a result of advanced disease progression; however, open wounds that appear very rapidly can also appear at end of life. The skin is an organ, and like other organs, it begins to stop functioning near life’s end. The goal of care for these wounds is to utilize pain medication to keep the person comfortable, attempt to prevent the wounds from worsening, and to keep them clean and free from infection, rather than attempting to heal them with aggressive (and possibly painful) invasive intervention or treatment. Your hospice or healthcare provider will provide guidance on how best to care for wounds and other changes in skin. Periods of rapid breathing, and no breathing for brief periods of time, coughing or noisy breaths, or increasingly shallow respirations, especially in final hours or days of life
Other changes in breathing
Agitation and periods of restlessness
Consciousness fades
Sensory changes
Illusions - They may misperceive a sound or get confused about an object in the room. They might hear the wind blow but think someone is crying, or they may see the lamp in the corner and think the lamp is a person. Hallucinations – They may hear voices that you cannot hear, see things that you cannot see, or feel things that you are unable to touch or feel. These hallucinations may be frightening or comforting to the dying person depending on their content. Delusions of persecution and delusions of grandeur – They may confuse reality and think others are trying to hurt them or cause them harm. They may believe that they can accomplish things that are not possible. Near death awareness – They may report awareness of their imminent death and express that they will soon be able to see their God or other religious figure or see loved friends and relatives who have preceded them in death. It is not uncommon for dying people to speak about preparing to take a trip, traveling, or activities related to travel, such as getting on a plane or packing a bag. Many dying persons find this awareness comforting, particularly the prospect of reunification. These sensory changes can wax and wane throughout the day and often become more pronounced at night. There are medications that can help alleviate symptoms that appear to be causing distress symptoms. Your hospice provider will decide whether medication is needed for these complex symptoms. Helpful Next Steps: Click here to see what can you do for your loved one NOW. Click here for Survival Tips for Grief. Click here for helpful articles about caregiving and grief. If you'd like more information about the sequence of events leading up to the moment of death, we suggest the book How We Die by Sherwin Nuland, M.D. (New York: Knopf, 1993). Learn more about hospice:
What are the physical signs and symptoms of approaching death?Physical signs that death is near include:. a sudden burst of energy.. mottled and blotchy skin, especially on the hands, feet and knees.. blood pressure decreases.. they cannot swallow.. less urine.. restlessness.. difficult breathing.. congested lungs.. What are 3 manifestations of approaching death?Pulse and heartbeat are irregular or hard to feel or hear. Body temperature drops. Skin on their knees, feet, and hands turns a mottled bluish-purple (often in the last 24 hours) Breathing is interrupted by gasping and slows until it stops entirely.
Which physical signs indicate to a nurse that a terminally ill client is approaching death select all that apply?The most common signs and symptoms before death include: increased pulse/respiratory rate, Cheyne-Stokes respirations, cool/mottled skin, and decreased urine output. It is important to provide support for the patient and family throughout the entire dying process.
Which physical assessment findings are physical signs of death?Five highly specific signs are loss of radial pulse; mandibular movement during breathing; anuria; Cheyne-Stokes breathing; and the “death rattle” from excessive oral secretions (see Fast Fact # 109) (6).
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