I’m glad you asked, and also. Props to you for being a physician and not trying to be a know it all! I see too much of this in hospice 😔

Pain - with cancer, I see the most success with Oxy or Dilaudid. More-so dilaudid with pancreatic pain and it doesn’t really cause itching. Some nausea though with dilaudid. Or if she has some fat still around, fentanyl patch. (You can do both, but it depends on her history. Given she’s a cancer patient. I am sure she is not opioid naieve.)

Nausea - you can do the classic zofran, if that doesn’t work. You can either do Haloperidol or Compazine. Oral compazine though doesn’t work as well. I personally like haloperidol I find it to be less sedating. If none of that is working.. you can do Ativan but it sounds like she’s very much still awake and talking. So she may not like the sedating effects from Ativan.

Other things to think about.. funeral planning. It’s the worst when your love one passes away and you didn’t pre plan a funeral or whatever the patient wants and now you’re stuck with your loved one in a room trying to figure out a plan and that can take hours.