The Case Continues...

Eight weeks later Mr Silver's home hospice nurse calls you to report that Mr Silver is now bed-bound and actively dying with an expected survival of 3-4 days. She reports that he is very weak and unable to swallow his oral medications anymore. His nurse also reports that the patient seems anxious and agitated with noisy breathing due to increased secretions.

Medications

Morphine Sulfate 60 mg every 12 hours
Morphine Sulfate rapidly disintegrating tablets 5 mg every 4 hours as needed.
Lorazepam 1 mg every 6 hours as needed.
Supplemental Oxygen through a room air concentrator.
Ipratropium bromide inhaler 2 puffs every 6 hours.
Decadron 16 mg every 6 hours You discontinue his oral medications as he is unable to swallow.