EXPECTED

PHYSIOLOGICA
L CHANGES
 Hello!

I am Camelle C. Dini-ay

2
 Physiological changes...

Cause of death varies from one case to another.

There is the physical death, that results from actual

cell death.

The events are irreversible, and will lead to somatic

changes.

3
 Physical changes

Appetite changes Breathing changes Increased weakness

- eat and drink less, or - may breathe faster and sleepiness
not at all or slower - General weakness
- Changes in your - moist and noisy - need more help to
metabolism walk, bathe, and use
the toilet
- coma

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 Physical changes

Urinary and bowel changes. Vision changes

- Urine dark brown or dark -you can't see well
red
- Stools (feces) may be hard
and difficult to pass
(constipation) as your fluid
intake decreases and you get
weaker

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 Physiological changes

▪ Increasing weakness, fatigue

▪ Cutaneous ischemia
▪ Decreasing appetite/fluid intake
▪ Cardiac, renal deterioration functions and decreased urine output
▪ Neurological deterioration , ranging from confusion to coma
▪ Pain
▪ Loss of ability to close eyes
▪ Gurgling sounds
▪ Death awareness
▪ etc.

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 Symptoms at EOL

Confusion/delirium :
hypoxia, metabolic and electrolytes imbalances, cerebral metastases, toxins accumulation in
renal and liver failure – irreversible

Manage by :
keep patients safe, reassure patients and family, encourage family members to keep
talking to their loves ones

Pharmacological :
D/C any drugs that may induce delirium
- neuroleptics (haloperidol, chlorpromazine)
- benzodiazepines (lorazepam , midazolam)
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 Symptoms at EOL

Weakness/fatigue :
no need for stimulants

Manage by :
minimize unnecessary movements, allow for rest, explain to family that
this is expected near death time

Surge of energy
- is noticed sometimes, we need to be on guard in not giving any false reassurance if you
are positive of the imminent signs of death, it's a good time for quality time with
family

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 Symptoms at EOL

Decreased oral intake :

-of both food and fluid, artificial support is not
recommended by literature, as it can cause many complications

-keep in mind energy requirements for dying persons

-It is a protective mechanism

-Frequent oral care is required

-Very distressing to the family: direct to another alternative care activities

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 Symptoms at EOL

Decreased blood perfusion:

-cardiac output decreases, kidneys are first to fail, skin mottling is common towards the
end.

• Vital signs changes:

- gasping ( irregular periodic apnea), common irreversible fever towards the end of life,
absence of radial pulse may indicate death in
few hours

How to manage: fluid replacements will not reverse the

circulatory collapse, paracetamol for fever, cool sponge baths is possible
Consider opioid dosage when renal failure.
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 Symptoms at EOL

Diminished swallow reflex:

- saliva accumulation, along with oropharyngeal
secretions, all will lead to gurgling sounds " death rattle“

How to manage :
• educating family about cause
• medications that dry up the secretions (glycoperronium/glycopyrronate,better than
atropine)
• repositioning client can be helpful to facilitate drainage

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 Symptoms at EOL

Incontinence / urinary retention:

- fatigue, loss of sphincter control can lead for this, disturbing for the family,
and affects patients' dignity

How to manage:
- education for family, Foley's might be useful.
If output is minimal, an absorbent pad would be enough.
If patient is restless and agitated, check for bladder distention, again
catheterization might be needed to empty the bladder if that is the case.

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 References

Gerinorth. (n.d.). Physiological Changes in Dying. Retrieved

September 13, 2022, from
https://www.slideshare.net/Gerinorth/physiological-changes-in-dying-
110132972

Physical and Emotional Changes as Death Approache November 11,

2022 from https://www.cham.org/HealthwiseArticle.aspx?id=aa150174

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Is the color of gold, butter and ripe Is the colour of the clear sky and the Is the color of blood, and because of
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light, yellow is found between green violet and green on the optical associated with sacrifice, danger
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 SWOT Analysis

STRENGTHS WEAKNESSES
Blue is the colour of the clear sky and Yellow is the color of gold, butter and
the deep sea ripe lemons

Black is the color of ebony and of outer White is the color of milk and fresh
space snow
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