DNR scope of care

Question

A client on a telemetry unit has a documented DNR order. The evening nurse prepares to give prescribed oral analgesics and change a draining wound dressing. A visiting relative says, "With a DNR, you should stop every treatment." Which response is most appropriate?

1. AExplain that the DNR decision applies to CPR if the heart or breathing stops and does not cancel other ordered care such as pain relief and wound care.✓ Correct

   A DNR order only directs staff not to perform CPR; other treatments continue unless separately limited.

2. BStop all medications and dressings immediately because a DNR voids every order.✗ Incorrect

   DNR does not eliminate ordinary comfort measures or other ordered therapies.

3. CBegin chest compressions now so the relative can see that resuscitation is still allowed.✗ Incorrect

   Performing CPR contrary to a valid DNR violates the client's documented preference.

4. DRemove the DNR from the record without discussing it with the client or the authorized decision-maker.✗ Incorrect

   Staff cannot unilaterally erase a properly established DNR order.

Answer

A. Explain that the DNR decision applies to CPR if the heart or breathing stops and does not cancel other ordered care such as pain relief and wound care.

Rationale

Families sometimes confuse a DNR with stopping all care. The order is narrow: it withholds CPR if circulation or breathing ceases. Pain control, wound care, and other ordered therapies remain appropriate unless a separate directive limits them.