Treatment Options for Dyspnea - Answer

Increase oxygen flow rate by applying a non-re-breather oxygen mask: No
While a trial of oxygen for symptom relief is advisable, with a saturation above 90%, higher oxygen flow rates are not likely to be effective and use of face mask may worsen his discomfort.

Ask his nurse to suction his oro-pharynx and trachea: No
Avoid endotracheal suctioning for symptom relief in most patients as it can be distressing.

Administer IV morphine sulfate: Yes
Morphine is the treatment of choice for relief of dyspnea, the most studied and versatile pharmacologic option.

Administer IV lorazepam: Maybe
Benzodiazepenes are considered a second line treatment for dyspnea in the palliative care patient and are certainly effective for treatment of associated anxiety. NOTE: when combined with opioids, they theoretically can produce additive sedative/CNS depressant effects which may or may not be desirable. But at the doses recommended for dyspnea, this is rarely clinically significant.

Administer albuterol nebulizer treatment: No
In the absence of evidence of bronchospasm, this is not likely to be effective.

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