— 照護管理 · HARD · MCQ —
一名簽署放棄急救（DNR）同意書的病人發生呼吸停止。家屬在場並強烈要求護理師立即施行 CPR。護理師的優先處置為何？
A client who has a DNR order experiences respiratory arrest. The family is present and demands that the nurse perform CPR immediately. What is the nurse's priority action?
- AInitiate CPR immediately to avoid a lawsuit立即開始心肺復甦術以避免訴訟
- BAsk the physician to override the DNR order請醫師撤銷放棄急救（DNR）指示
- CExplain to the family that the DNR order must be honored✓ 正解向家屬解釋必須遵守放棄急救（DNR）指示
- DCall the hospital ethics committee呼叫醫院倫理委員會
— Explanation · 中文詳解 —
DNR 同意書具有法律效力。當病人已簽署且指令明確時，護理師的法律義務是遵守病人的自主意志。面臨家屬壓力時，應冷靜、堅定地告知家屬病人當初的決定，並提供情緒支持，而非屈服於壓力而違反病人意願進行急救。
A DNR order is legally binding. When the patient has signed it and the directive is clear, the nurse is legally obligated to honor the patient's autonomous wishes. In the face of family pressure, the nurse should calmly and firmly inform the family of the patient's prior decision and provide emotional support, rather than yield to pressure and violate the patient's wishes by initiating resuscitation.
✦ 台美臨床差異
台灣目前對於 DNR 的推動與執行，常因家屬不同意而有執行困難，但在法律層面上，護理師應以維護病人自主權為優先。