Death – Comfort Care orders

Death: Comfort Care

  • Morphine 250mg / NS IV. Starting dose: 1mg/hr @ titrate ml/hr (Dosage range 1 to 80 mg/hr). [1mg/hr]
    1. Morphine 2mg IV q3hr PRN breakthrough pain
    2. Fentanyl 50mcg IV q2hr PRN pain or “air hunger”
  • PRN meds:
    1. Atropine 1% ophtho drops: 1 drop SL (sublingual) q1hr PRN for oral secretions
    2. Tylenol soln 650mg F-tube q4hrs PRN fever greater than 101F per feeding tube
      1. Tylenol 650mg PO q4hr PRN mid-mod pain, fever. Tylenol suppository q6hr PRN.
    3. Ativan (Lorazepam) 1-2mg PO/IV q2-8hr PRN anxiety or “air hunger”
    4. Scopolamine 1.5mg/72hr (transderm-scop) 1 patch q3days (nausea/vomiting, motion sickness)
      1. Prevent excessive salivation.
    5. Zofran 8mg IV q2hr PRN N/V
    6. Glycopyrrolate (Robinul) 1ml IM q8hrs (0.4mg IV q4hrs PRN): reduce volume of salivary, tracheobronchial, pharyngeal, and gastric secretions.
    7. NS PF 20ml (2 vials) IV demand PRN flushing protocol (PICC flush after each use)

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