一位 45 歲患有廣泛性焦慮症的病人出現心跳過速與呼吸困難。護理師應採取何種優先處置？
A 45-year-old client with a history of generalized anxiety disorder presents with rapid heart rate and shortness of breath. Which nursing intervention is the highest priority?
- APerform a physical assessment to rule out cardiac issues進行身體評估以排除心臟問題
- BCall the psychiatric consultant呼叫精神科會診
- CInstruct the client to breathe slowly with the nurse✓ 正解指導病人与護理師一起緩慢呼吸
- DAdminister a PRN dose of an anxiolytic給予處方用抗焦慮藥物
面對廣泛性焦慮症（Generalized Anxiety Disorder, GAD）病人的急性心悸與呼吸困難，護理師的首要目標是穩定病人的生理狀態。焦慮發作常引發過度換氣（Hyperventilation），導致二氧化碳過低，進而加劇心悸與呼吸困難。引導病人進行緩慢的腹式呼吸，能直接活化副交感神經系統（Parasympathetic Nervous System），降低心跳速率並重新獲得對生理的控制感。這是非藥物治療中最立即且有效的介入，能避免病人因恐慌而陷入更嚴重的生理失調。
Guided slow breathing is the highest priority intervention as it immediately activates the parasympathetic nervous system to reduce tachycardia and hyperventilation associated with acute anxiety. This non-pharmacological approach stabilizes physiological symptoms before other assessments or medications are initiated.
在美國臨床執業中，護理師需具備高度的臨床判斷力，優先評估是否為單純焦慮或潛在的心肌梗塞。若病人有心臟病史，護理師會同步監測生命徵象並備妥心電圖，但穩定呼吸仍是護理師的第一手介入。