一位處於嚴重躁症發作的病人正在走廊走動並對其他病人大聲叫喊。護理師應先採取哪項行動？

面對處於嚴重躁症（severe mania）發作且行為激動的病人，護理師的首要任務是確保病人、其他病人和工作人員的安全。在精神科護理中，遵循「最低限制性干預（least restrictive intervention）」原則是至關重要的。這意味著在可能的情況下，應優先採取非侵入性或限制性較低的措施來控制情勢，而不是直接使用更具限制性的手段，例如身體約束或鎮靜藥物。 將病人轉移到安靜區域（quiet area）是一種有效的非藥物、非限制性干預措施。這有助於減少環境刺激，降低病人的激動程度，並提供一個相對安全的空間，讓護理師能夠進行治療性溝通。若病人能夠被引導至安靜區域，這不僅能保護其他病人免受干擾，也能避免對躁症病人採取更具限制性的措施，同時維護其尊嚴。只有在非限制性措施無效或安全受到嚴重威脅時，才考慮升級干預措施。

When dealing with a client in severe mania who is exhibiting agitated behavior, the nurse's primary task is to ensure the safety of the client, other clients, and staff. In psychiatric nursing, following the principle of 'least restrictive intervention' is crucial. This means that whenever possible, non-invasive or less restrictive measures should be prioritized to manage the situation, rather than directly using more restrictive means such as physical restraints or sedative medications. Redirecting the client to a quiet area is an effective non-pharmacologic, non-restrictive intervention. This helps reduce environmental stimuli, lower the client's agitation level, and provide a relatively safe space in which the nurse can conduct therapeutic communication. If the client can be guided to a quiet area, this not only protects other clients from disturbance but also avoids the use of more restrictive measures on the manic client, while preserving the client's dignity. Only when non-restrictive measures are ineffective or safety is severely threatened should escalation of interventions be considered.

在美國，精神科護理強調最低限制性（least restrictive）原則，身體約束和強制給藥有嚴格的法律和倫理限制。護理師在採取這些措施前，必須證明所有較低限制性的干預都已嘗試且無效。台灣精神科對於約束的使用可能相對較頻繁，但近年也逐漸強調非藥物和最低限制性措施的應用。