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照護管理 · MEDIUM · SATA

護理師照護一位有「不施行心肺復甦術」(DNR)醫囑的病人。若病人停止呼吸,下列哪些處置是適當的?(選所有適合的)

A nurse is providing care for a client with a do-not-resuscitate (DNR) order. Which of the following actions are appropriate for the nurse to perform if the client stops breathing? (Select all that apply.)

  • AAdminister pain medication for comfort✓ 正解
    給予止痛藥以提供舒適
  • BProvide oxygen to relieve dyspnea✓ 正解
    給予氧氣以緩解呼吸困難
  • CPerform chest compressions
    執行胸外按壓
  • DContact the physician to declare death✓ 正解
    聯絡醫師宣告死亡
  • EPerform endotracheal intubation
    執行氣管內插管
Explanation · 中文詳解

DNR(不施行心肺復甦術)醫囑僅針對心跳或呼吸停止時的「急救措施」。它並不代表放棄治療,護理師仍需提供「舒適照護(Comfort Care)」與「安寧照護(Palliative Care)」。給予氧氣改善呼吸困難、使用止痛藥緩解疼痛,皆是維護病患尊嚴與減輕痛苦的責任。但 chest compressions 與 intubation 等侵入性急救措施在 DNR 下是嚴格禁止的。

A DNR (Do Not Resuscitate) order only addresses resuscitative measures when the heartbeat or breathing stops. It does not mean abandoning care; the nurse must still provide comfort care and palliative care. Providing oxygen to relieve dyspnea and administering analgesics to alleviate pain are responsibilities aimed at preserving the patient's dignity and reducing suffering. However, invasive resuscitative measures such as chest compressions and intubation are strictly prohibited under DNR.

✦ 台美臨床差異

在美國,DNR 醫囑通常需要醫師簽署,且需在病歷中清楚標示。若病患有 DNR,護理師在執行任何照護前,務必確認醫囑範圍,因為有些病患會簽署 DNR 但仍接受插管(DNI),或針對不同情況有不同意願。

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