Comfort care med protocol?? - page 2

70 year old pt CHF, ESRD on a vent with dyspnea , b/p 70/30 currently on comfort care only. Dr ordered ativan 4mg/ morphine 4 mg IVP . Due to the difficulty in breathing I gave the morphine dose... Read More

  1. by   leslymill
    You could ask for an order to titrate up to 4mg of Ativan Q4 hrs. so if less does the trick you can hold there.
  2. by   leslie :-D
    Quote from leslymill
    You could ask for an order to titrate up to 4mg of Ativan Q4 hrs. so if less does the trick you can hold there.
    exactly.
    to randomly give 4mg of ativan in a geriatric, esrd pt is dangerous.

    i'm the first one to want to appease one's suffering.
    but my yrs of experience strongly tells me that 4mg is pushing it way over the edge.

    leslie
  3. by   Tweety
    Quote from starcandy
    This is what I did I gave the morphine and pt was sedated resps decreased from 30's to low 20's. It was ordered q 1 hr prn. I know the goal is to maintain comfort but I did not want to be the one to speed up her impending death. I assume terminal weaning wwill be discussed very soon.
    I agree, not being the one to give the "death dose" is a tough one for many of us when dealing with the actively dying.

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