Hospice Nursing advice

[Animorpha]

I don't have a lot of experience with Hospice as an RN, but I recently had a pt with lung cancer that metastasized to his jaw and femur. By the time he was my patient he was actively dying. The nurse on the shift before me had been giving him prn ativan Q2hr and prn morphine Q1hr. I ended up giving him prn morphine again an hour later, but after that his breathing showed much more apnea and the pt overall just looked more relaxed. I gave the pt his scheduled ER morphine, but that was the last time during the shift I gave him morphine of any kind because physically the pt did not look like he was in any pain or distress whatsoever. His breathing because more chenye-stokes as the shift went on.

My other problem was his temperature being so high. During the previous shift despite giving PR Tylenol q4hr and cooling measures the pt's temperature remained above 103 F. The daughter had told the previous nurse to not bother with the Tylenol anymore because it doesn't seem to be helping the pt so why bother the pt to give it PR and make the pt uncomfortable. So, when I got the pt I decided to follow what the daughter had said and not give the Tylenol since it was ineffective the shift prior anyway. I had cooling measures going the whole shift though. By the time the next shift came in the pt's temp had risen 105 and the nursing coming on looked at me like I was the most horrible person ever for not giving the Tylenol. I've been thinking about it ever since.

What is protocol with at pt with this diagnosis regarding managing pain, breathing, and temp? Thanks!