# 一位 78 歲患有晚期失智症的客戶因吸入性肺炎入院。客戶無法溝通且沒有預立醫療指示。醫療團隊需要確定代理決策者。護理師應採取哪些行動？請選出所有適用項目。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=505781&lang=zh-tw  
> language: zh-TW  
> subject: Management of Care  
> category: MOC

## 題目

一位 78 歲患有晚期失智症的客戶因吸入性肺炎入院。客戶無法溝通且沒有預立醫療指示。醫療團隊需要確定代理決策者。護理師應採取哪些行動？請選出所有適用項目。

1

與醫院的法務或倫理資源確認州法律規定的代理人優先順序。

2

詢問成年子女個案是否曾填寫任何治療偏好文件。

3

指定主治醫師擔任個案的代理決策者。

4

檢閱先前的紀錄，尋找指定健康照護代理人或授權書的文件。

5

延後決定，直到個案恢復足夠的行為能力能自行選擇。

6

聯繫配偶，並確認該人根據適用的州法律是否具有優先權。

## 解析

當個案缺乏決策能力時，護理師應尋找已指定的代理人，並遵循適用的州法律和機構政策。檢閱先前的紀錄以尋找健康照護授權書，以及詢問成年子女相關文件，可以找出指定的決策者。醫院的法務或倫理資源可以確認該司法管轄區的代理人優先順序，而配偶應被聯繫，同時護理師需確認該人的法律優先權。主治醫師並非自動成為代理人，且不應為了等待患有重度失智症的個案恢復行為能力而延遲必要的決定。

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