Breathing tx during active dying process

[ReeseCup819]

What are your thoughts, feelings, opinions, knowledge about using breathing treatments for a pt who is actively dying. Especially those who are very agitated. I had a pt who was mostly unresponsive, but when he did wake up he was very confused and agitated. He was given Haldol ATC and ativan prn for it. He started getting congested and has an order for the breathing tx, but I feel like the steriod would just make the agitation worse. I decided just to use the atropine to dry the secretions up.

What do you think?

[leslie :-D]

What are your thoughts, feelings, opinions, knowledge about using breathing treatments for a pt who is actively dying. Especially those who are very agitated. I had a pt who was mostly unresponsive, but when he did wake up he was very confused and agitated. He was given Haldol ATC and ativan prn for it. He started getting congested and has an order for the breathing tx, but I feel like the steriod would just make the agitation worse. I decided just to use the atropine to dry the secretions up.

What do you think?

that was a good call on your part.

you're going to have to get aggessive w/the atropine, because his lungs will steadily fill.

you may even want to put on a scope patch, which i find works the best.

i might consider changing the ativan, since some do get a paradoxical agitation from it.

we use thorazine for different reasons, but is always good for agitation.

finally, can he be talked down during his agitation?

maybe he's in pain?

or even constipated?

it would be wise to r/o all etio's before randomly increasing/changing meds.

wishing you the very best.

leslie