Lauer- The End of Life Flashcards
What is anorexia?
loss of appetite
What is cachexia?
weight loss with muscle wasting
Why do people stop eating at the end of life?
The stop eating because their body can’t use it
What mediates cachexia/anorexia?
cytokines
anabolic to metabolic phase in body
NOT-disease specific
weeks to months
What are the symptoms that can follow if you fail to honor hunger and thirst signals?
abdominal pain nausea and vomiting diarrhea edema urinary retention
What is transitioning?
The tipping point between living and actively dying
What does transitioning usually occur?
1-2 weeks before death
What physical changes often accompany transitioning?
changes in alertness
picking/removing clothes
hallucinations
escalating symptoms
Active dying is predominantly dependent on what?
CIRCULATION
–>body is programmed to protect the most important stuff, everything else is shut down based on how far it is from the important stuff
What happens to the lower extremities in an actively dying pt?
color chagnes (mottling, pallor, cyanosis)
cold
thready or absent pulses
What happens to the genitourinary system in an actively dying pt?
incontinence
urinary retention
decreased urine output
What happens in the GI tract of a actively dying pt?
bowel incontinence
constipation (morphine)
poor appetite–> poor motility
hiccups
What happens to the mouth and esophagus in an actively dying pt?
poor oral transit
weak swallow
death rattle–> can’t manage own secretions
What happens to the upper extremities in an actively dying pt?
cyanosis/mottling
cold
pulses usually good to the end of life
usually seen at the same time as face
When do you often see changes in the upper extremities?
Within hours of deat
