— 照護管理 · MEDIUM · MCQ —
護理師照顧 DNR 病人，若病人發生心跳停止，責任為何？
A nurse is caring for a client with a DNR order. What is the nurse's responsibility if the client experiences cardiac arrest?
- AImmediately initiate CPR立即開始心肺復甦術
- BFollow the DNR order and refrain from resuscitation✓ 正解遵循DNR指示並避免進行復甦
- CContact the family to ask for permission to start CPR聯繫家屬以詢問是否同意開始心肺復甦
- DCall a code blue呼叫Code Blue（緊急醫療團隊）
— Explanation · 中文詳解 —
DNR（Do Not Resuscitate）訂單在美國具有嚴格的法律約束力，代表病人已明確表達在心肺停止時拒絕侵入性急救。當病人發生心跳停止，護理師的職責是尊重病人的自主權（Autonomy），停止所有心肺復甦術（CPR）相關處置。重點在於將照護重心轉向臨終關懷（Comfort Care），減輕病人的痛苦，而非進行無效醫療。
A DNR (Do Not Resuscitate) order is legally binding and reflects the client's expressed wish to refuse invasive resuscitation in the event of cardiopulmonary arrest. When arrest occurs, the nurse must respect the client's autonomy and refrain from CPR. Care is redirected toward comfort and end-of-life support rather than aggressive intervention.
✦ 台美臨床差異
在美國，DNR 必須有醫師簽署的具體醫囑，若病人轉院或改變照護層級，護理師需確認 DNR 狀態是否隨之轉移（如 POLST/MOLST 系統）。