When a client has no pulse or respirations and there is no DNR or AND prescription in the medical record, what is the nurse's initial action?

When a client has no pulse or respirations and there is no DNR or AND prescription in the medical record, what is the nurse's initial action?

• A. Initiate CPR
• B. Contact the Attorney
• C. Assess Vital Signs for 30 Minutes
• D. Wait for Physician's Order

Answer: (A)

The essential idea is that in an emergency, when a person has no pulse or respirations and there’s no advance directive on file, you begin life‑saving efforts right away. Initiating CPR without delay reflects the default standard of care: preserve life unless there is a clear, documented wish to withhold resuscitation. So start chest compressions immediately and call for help or activate the code/rapid response system. Continue according to your facility’s CPR protocol, providing breaths if trained and able, while you maintain high-quality compressions and minimize interruptions. Delaying action to obtain orders or to perform nonurgent tasks would reduce the chance of survival, and waiting for a physician’s order or pursuing non-emergent steps isn’t appropriate in this immediate life‑threatening scenario.

The essential idea is that in an emergency, when a person has no pulse or respirations and there’s no advance directive on file, you begin life‑saving efforts right away. Initiating CPR without delay reflects the default standard of care: preserve life unless there is a clear, documented wish to withhold resuscitation. So start chest compressions immediately and call for help or activate the code/rapid response system. Continue according to your facility’s CPR protocol, providing breaths if trained and able, while you maintain high-quality compressions and minimize interruptions. Delaying action to obtain orders or to perform nonurgent tasks would reduce the chance of survival, and waiting for a physician’s order or pursuing non-emergent steps isn’t appropriate in this immediate life‑threatening scenario.