joannotrealname

Thanks, MunoRN--very helpful! Expanding my knowledge and understanding!

Thanks for the responses! This is very helpful. Sorry for the confusion in my questions. The crux of my questions was whether or not morphine could exacerbate brain swelling in a dying stroke patient who has both 1) brain swelling, and 2) signs of renal failure (reduced, black urine) that might enhance the drug's effects. I'd read several technical sources that said morphine can increase intracranial pressure (ICP), but others that say untreated pain can raise ICP as well--hence my confusion.

http://www.nursingcenter.com/lnc/static?pageid=1255264 I wanted to get your input on what you think of this article, and how many of you encounter situations where reducing morphine in the dying, hospice patient might be in order to prevent more pain and discomfort, as mentioned here. Is this actively considered in the hospice environment? Also, have any of you encountered conditions in which morphine in the hospice patient with dyspnea might be contraindicated? e.g., brain swelling in stroke, with or without adequate hydration?