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一位缺乏決策能力的成年個案有一份預立醫療指示，指定配偶為健康照護代理人。成年子女要求護理師忽略配偶，改採另一項計畫。目前沒有立即的緊急狀況。請完成下列照護管理判斷。

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The nurse should first ::선택::ask the family to vote on who should decideverify the directive, the capacity determination, and the named agent's authority under policy and lawremove the directive from the record until the family agreesaccept the adult child's request because the child is biologically related. Decisions should then ::선택::base the plan on whichever relative arrives firstreplace the client's prior wishes with the nurse's view of the best outcomework with the authorized agent using the client's documented wishes, values, and best interestsask unlicensed personnel to resolve the disagreement. If the conflict remains unresolved, the nurse should ::선택::continue current safe care, document objective facts, and escalate to the provider, leadership, and ethics or legal resources according to policystop all care until every relative agreespromise the child that the directive will not be followeddelay reporting the conflict until discharge.

護理師應先 ::선택::要求家屬以投票選出決策者依政策與法律核實指示、決策能力判定及指定代理人的權限在家屬達成共識前，將指示從病歷中移除僅因成年子女與個案有血緣關係就接受其要求。接著，決策應 ::선택::依照最先到場親屬的意見進行以護理師認為最好的結果取代個案先前的意願與授權代理人合作，依據個案記錄的意願、價值觀與最佳利益進行交由無照輔助人員處理。若衝突仍未解決，護理師應 ::선택::持續目前的安全照護、記錄客觀事實，並依政策向醫療團隊、護理主管及倫理或法務部門通報停止所有照護，直到所有親屬達成共識向子女承諾不會遵循指示延遲通報衝突直到出院。

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