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一位護理師接到醫囑，為一位鴉片類藥物未曾使用過的75歲個案，在小型門診手術後，每2小時需要時靜脈推注hydromorphone 4 mg。護理師認為此劑量不安全。哪些行動顯示倡議及適當運用指揮鏈？請選出所有適用者。

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1 Withhold the medication and contact the prescriber to clarify the dose, stating the specific safety concerns 暫停給藥並聯繫開立醫囑者以澄清劑量，說明具體的安全疑慮 2 Document the order, safety concern, communication with the prescriber, and response according to policy 依政策記錄醫囑、安全疑慮、與開立醫囑者的溝通及回應 3 If the concern remains unresolved, escalate through the facility's chain of command before administration 若疑慮仍未解決，在給藥前透過機構的指揮鏈進行通報 4 Do not administer a medication the nurse reasonably believes is unsafe, recognizing independent accountability for medication administration 不給予護理師合理認為不安全的藥物，體認到給藥的獨立當責 5 Administer the dose as written because the prescriber believes it is safe and the prescriber's judgment supersedes the nurse's medication-safety concern 依書面醫囑給予該劑量，因為處方者認為其安全，且處方者的判斷凌駕於護理師的用藥安全疑慮 6 File an incident report for the next manager to review instead of contacting the prescriber or using the chain of command for the active medication concern 提交異常事件報告供下一位管理者審查，而非針對當前的用藥疑慮聯繫處方者或使用指揮鏈

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