Hi - I am a hospice nurse. I have a patient who is full of cancer (lungs, breast, abdomen with liver involvement). Her history includes cardiac problems w/MI, CHF, HTN, CAD, CVA, and A-fib and she is morbidly obese. Her pain med of vicoden QID was not effective and due to her cancer, morphine was recommended. At first it was PRN, but with continued cries of pain was schedule Q4H and Q1H PRN. Although her appetite was dwindling, she stopped intake on Friday. She also was acting weird, not herself. Her vital signs at that time included a B/P of 160/80 and a heart rate of 130-134. I called the facility where she is staying today to get an update and found that she continues with no PO intake and her heart rate is now sustained in the 170s. I suspected heart involvement on Friday vs morphine adverse reaction. Today I am at the same conclusion. Could you provide any insight into this scenario? I am not familiar with an adverse reaction to morphine like this and when I researched, found nothing specific to this scenario. Obviously have cardiac involvement and am wondering a course of action or direction for the facility to take today. Should the morphine be d/c d? Note: Pt is a DNR. Thank you for your time.