What is a Do Not Resuscitate (DNR) order and how should it be implemented?

• A. It indicates CPR should not be attempted if the patient arrests; it must be documented, communicated to the care team, and followed, while other treatments continue unless otherwise specified.
• B. It requires cessation of all medical treatment.
• C. It can be changed only by the patient.
• D. It is a legally binding document that ends all care.

Answer: (A)

A DNR order means that if the patient’s heart stops or they stop breathing, CPR should not be attempted. It focuses only on resuscitation; it does not mean all medical care stops. Other treatments, such as comfort measures, medications, and ongoing treatments for the underlying illness, can continue unless the patient, or a legally authorized surrogate if the patient can’t speak for themselves, specifies otherwise.

Implementation hinges on clear, documented authorization written by a clinician and placed in the medical record, then communicated to all members of the care team and honored across settings. Because patients’ goals can change, a DNR is revisited and can be updated or revoked if the patient regains capacity or if a surrogate determines the patient’s preferences have changed. It’s not a blanket end to care and it’s not typically restricted to patient-only changes when a surrogate is involved.