一位 45 歲患有廣泛性焦慮症的個案表現出心悸、盜汗及瀕死感。護理師首要採取的介入措施為何？
A 45-year-old client with a history of generalized anxiety disorder presents with reports of palpitations, sweating, and feelings of impending doom. Which intervention is the priority for the nurse to implement first?
- AMaintain a calm, quiet, and non-stimulating environment✓ 正解維持安靜、無刺激的平靜環境
- BTeach the client deep breathing techniques教導病人深呼吸技巧
- CInstruct the client to breathe into a paper bag指示病人用紙袋呼吸
- DAdminister the prescribed PRN anxiolytic medication給予處方上的按需（PRN）抗焦慮藥物
面對焦慮發作（Panic Attack）的個案，營造安全且低刺激的環境能最快降低個案的感官過載，進而穩定情緒。過度刺激會加重焦慮反應。袋內呼吸法已不再推薦使用，因為可能導致二氧化碳過高；藥物給予需醫師醫囑且非首要；呼吸技巧教學需在個案情緒稍微平復後才有效。
When confronting a panic attack, creating a safe, low-stimulation environment most rapidly reduces sensory overload and stabilizes the client. Excessive stimulation worsens the anxiety response. Paper-bag breathing is no longer recommended because it can cause hypercapnia; medication administration requires a physician's order and is not the priority; and breathing technique instruction is effective only after the client's emotions have begun to settle.
美國護理師常主導環境調整，台灣臨床單位因病房擁擠，此類個案常被放置於護理站旁觀察，環境安寧度控制較受限。