— 照護管理 · MEDIUM · MCQ —
護理師照顧一位簽署 DNR（拒絕心肺復甦術）的病人，當病人停止呼吸時，首要護理重點為何？
A nurse is providing care for a client with a DNR order. What is the nurse's priority when the client stops breathing?
- ABegin chest compressions immediately立即開始胸外按壓
- BProvide comfort and support the family✓ 正解提供舒適護理並支持家屬
- CPrepare the intubation tray準備插管盤
- DCall a code blue呼叫 Code Blue（搶救團隊）
— Explanation · 中文詳解 —
簽署 DNR（Do Not Resuscitate）意指病人拒絕心肺復甦術，包括胸外按壓、電擊與強心藥物。當病人生命徵象停止時，護理重點應立即轉向緩和照護（Palliative care），即提供舒適護理（Comfort care）與心理支持（Supporting the family），維持尊嚴，而非繼續進行無效的醫療搶救。
A Do Not Resuscitate (DNR) order prohibits interventions such as chest compressions, defibrillation, and intubation. When a client with a DNR order stops breathing, the nurse's priority shifts to palliative care, focusing on comfort and supporting the family. The nurse should maintain the client's dignity without initiating life-saving measures.
✦ 台美臨床差異
在美國，DNR 必須有醫師簽署的明確醫囑，甚至在社區中有特定的 MOLST（Medical Orders for Life-Sustaining Treatment）表單，護理師必須確認文件的有效性與適用範圍。