— 照護管理 · HARD · MCQ —
一位病人持有 DNR（拒絕心肺復甦術）醫囑。其配偶要求護理師撤銷該醫囑，因為病人「好轉中」。護理師應如何回應？
A nurse is caring for a client with a DNR order. The client's spouse requests that the nurse remove the DNR order because the client is 'getting better.' How should the nurse respond?
- AInform the spouse that the DNR order cannot be changed告知配偶DNR醫囑無法更改
- BCall a family meeting to discuss the client's current status召開家庭會議討論病人的目前狀況
- CRemove the DNR order immediately as the spouse is the legal proxy立即撤銷DNR醫囑，因為配偶是法定代理人
- DAdvise the spouse to discuss this request with the physician✓ 正解建議配偶與醫師討論此請求
— Explanation · 中文詳解 —
DNR 是醫療醫囑，撤銷或修改必須由主治醫師評估病人意願或與家屬協商後決定。護理師無權自行更改醫囑。雖然配偶可能是醫療代理人（Proxy），但護理師應引導其與醫師溝通，讓醫師評估病人的病情變化與法律授權範圍，確保決策的醫療專業性與安全性。
A Do Not Resuscitate (DNR) order is a medical directive that requires the primary physician to evaluate the patient's condition and wishes before revocation or modification. Although the spouse may be the legal healthcare proxy, the nurse cannot independently alter medical orders and must advise the spouse to discuss the request directly with the physician.
✦ 台美臨床差異
美國法規對於 AD（預立醫療指示）與 DNR 流程有嚴格的法律保護；台灣則依《病人自主權利法》執行，強調意願人的事前自主意願。