— 照護管理 · MEDIUM · MCQ —
護理師照顧一位簽署 DNR（不施行心肺復甦術）的病人，若病人呼吸停止，應採取何種行動？
A nurse is caring for a client with a do-not-resuscitate (DNR) order. Which action is appropriate if the client stops breathing?
- AProvide comfort care and notify the physician✓ 正解提供舒適護理並通知醫師
- BBegin rescue breathing to maintain oxygenation開始急救呼吸以維持氧合
- CCall the code team to perform intubation呼叫急救團隊進行氣管插管
- DInitiate chest compressions immediately立即開始胸部按壓
— Explanation · 中文詳解 —
DNR 指令僅拒絕心肺復甦術（胸部按壓、插管、電擊），並不等於放棄所有治療。在病人呼吸停止時，護理師應提供臨終關懷（舒適護理），並依照醫療常規通知醫師宣告死亡或啟動死亡後護理程序。其他選項皆為復甦術範疇，違反 DNR 意願。
A do-not-resuscitate (DNR) order specifically declines cardiopulmonary resuscitation measures such as chest compressions, intubation, and defibrillation. When the client stops breathing, the nurse should provide comfort care and notify the physician, as initiating resuscitation would violate the client's wishes.
✦ 台美臨床差異
台灣 DNR 執行需符合安寧緩和醫療條例，且需與家屬溝通確認，美國 DNR 較多由病人自主決定並即時執行。