Profound progressive weakness |
Bed-bound state |
Sleeping much of the time |
Indifference to food and fluids |
Difficulty swallowing |
Disorientation to time, with increasingly short attention span |
Low or lower blood pressure not related to hypovolemia |
Urinary incontinence or retention caused by weakness |
Oliguria |
Loss of ability to close eyes |
Hallucinations involving previously deceased important individuals |
References to going home or similar themes |
Changes in respiratory rate and pattern (Cheyne-Stokes breathing, apneas) |
Noisy breathing, pooling of airway secretions |
Mottling and cooling of the skin due to vasomotor instability with venous pooling, particularly tibial |
Dropping blood pressure with rising, weak pulse |
Mental status changes (delirium, restlessness, agitation, coma) |
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