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____________________ ____________________ generally starts in the legs and works its way up to the trunk until the patient becomes bedbound . ____________________ may start with coughing or sputtering , the patient may start with moist or soft foods , until he or she can no longer tolerate intake . When the ____________________ slows down the patient will often become cool to touch on their boney prominences , they may also develop ____________________ tinged lips and a waxy pallor to their skin . The ____________________ ____________________ system may malfunction cuasing your patient to be cold one moment and feverish the next . As death nears the ____________________ function will decrease , particulary 24 hours prior to death , causing a ____________________ in urine output . ____________________ ____________________ are caused by relaxation of the soft palate in the throat with phlegm vibrating against the vocal cords .