A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?

A. The client has become addicted to the medication. – Addiction involves compulsive drug-seeking behavior and use despite harm. In a hospice setting, tolerance and dependence are expected and should not be confused with addiction. B. The client is experiencing episodes of confusion. – While morphine may cause confusion, especially in elderly or very ill clients, this does not explain the need for a higher dose for pain relief. C. The client developed a tolerance to the medication. – Tolerance occurs when the body becomes accustomed to a drug, requiring higher doses to achieve the same effect. This is common with long-term opioid use for chronic or terminal pain. D. The client has not been taking the medication properly. – There is no indication of noncompliance. The need for a higher dose is more accurately attributed to tolerance, especially in terminal illness.