— 照護管理 · MEDIUM · MCQ —
護理師照顧一位簽有 DNR（不施行心肺復甦術）的病人，病人突然停止呼吸，護理師應優先做什麼？
A nurse is caring for a client with a DNR (Do Not Resuscitate) order. The client suddenly stops breathing. What should the nurse do first?
- AAssess for a carotid pulse✓ 正解評估頸動脈脈搏
- BBegin chest compressions immediately立即開始胸外按壓
- CCheck the medical record to confirm the DNR order is signed查閱病歷以確認 DNR 指示已簽署
- DCall the physician to report the death打電話通知醫師病人已死亡
— Explanation · 中文詳解 —
即使有 DNR 醫囑，護理師仍需確認病人的生命跡象。確認脈搏（A）是評估病人心跳停止與否的標準檢查。若確實無脈搏，則遵循 DNR 醫囑執行善終護理；若有脈搏但呼吸停止，則需給予呼吸支持，而非直接放棄急救。
Even when a DNR order is in place, the nurse must still confirm the client's vital signs. Checking for a pulse (A) is the standard step to assess whether cardiac arrest has occurred. If no pulse is detected, the nurse follows the DNR order and provides end-of-life care; if a pulse is present but breathing has stopped, respiratory support is required rather than withholding resuscitation altogether.
✦ 台美臨床差異
美國 DNR 執行非常徹底；台灣在 DNR 執行時，常面臨家屬壓力，護理師需在法律與人情間尋求平衡。