I work in a LTC facility as a CRNP and often times I am in charge of the end of life issues even if I order hospice. I have had the scenario of an elderly 80's something patient with aspiration pneumonia on almost a weekly basis. If the antibiotics have not worked early in the course of the illness, they are not going to. I routinely give all my dying patients orders for Roxanol which is liquid morphine sublingually or a Morphine Drip. This helps them die comfortably and in peace without gasping for their breath which is an awful thing for the family to watch. As for the B/P, I do not take the B/P at all but rather use tachycardia or tachypnea as markers for medicating these patients.
Re the DNR without having spoken to the family---this is illegal and should be reported.