— 照護管理 · HARD · MCQ —
護理師負責一位有 DNR（拒絕心肺復甦術）醫囑的病人，病人突然停止呼吸。護理師應優先採取何項措施？
A nurse is responsible for a patient with a DNR (Do Not Resuscitate) order. The patient stops breathing. What is the nurse's priority action?
- ANotify the physician of the change in status✓ 正解通知醫師病情變化
- BInitiate CPR immediately立即開始心肺復甦術
- CVerify the DNR order validity in the chart查核病歷中DNR醫囑的有效性
- DConsult the family members before doing anything採取任何行動前諮詢家屬
— Explanation · 中文詳解 —
當病人停止呼吸且有有效的 DNR 醫囑時，護理師應尊重該醫囑，停止嘗試 CPR，並通知醫師以宣告病人狀況及開立死亡證明或相關處置。若貿然執行 CPR 則違反病人意願與醫療倫理。通知醫師是為了確診死亡與後續程序。
When a client with a valid Do Not Resuscitate (DNR) order stops breathing, the nurse must respect the client's wishes by withholding CPR and notifying the physician to confirm death and initiate post-mortem procedures. Initiating CPR would violate the DNR order and ethical standards, while verifying the order or consulting family are not the immediate priorities once the order is known to be valid.
✦ 台美臨床差異
美國 DNR 具強大法律效力；台灣病人自主權利法雖推廣，但臨床護理師常面臨家屬壓力而被迫進行無效急救，需加強法規宣導。