— 心理社會完整性 · MEDIUM · MCQ —
一位 45 歲廣泛性焦慮症患者表示擔心失去控制。護理師在急性發作期間的首要處置為何？
A 45-year-old client diagnosed with generalized anxiety disorder expresses fear of losing control. Which nursing intervention is the highest priority during an acute episode?
- AAdminister an PRN anxiolytic medication給予處方箋藥物（PRN）抗焦慮藥物
- BInstruct the client to breathe deeply and slowly指示客戶深呼吸並放慢速度
- CEncourage the client to discuss the source of anxiety鼓勵客戶討論焦慮的來源
- DReduce environmental stimuli by placing the client in a quiet room✓ 正解將客戶安置於安靜的房間，減少環境刺激
— Explanation · 中文詳解 —
面對廣泛性焦慮症（GAD）急性發作，首要目標是降低焦慮強度並防止個案失去控制。減少環境刺激是護理介入的基礎，能有效降低個案的神經喚起狀態（Over-arousal）。當環境變得安靜、單純，個案才更有可能冷靜下來。此時進行深度溝通或教導複雜技巧通常無效，因為個案處於高焦慮狀態時，認知能力會下降，優先應提供安全且低刺激的環境。
Reducing environmental stimuli by placing the client in a quiet room is the priority intervention to lower sensory overload and help the client regain a sense of control. During an acute anxiety episode, cognitive processing is impaired, making complex discussions or teaching ineffective until the client is calmer.
✦ 台美臨床差異
美國臨床更強調「去升級（De-escalation）」技術，即在不限制自由的前提下，透過環境與溝通穩定情緒，而非過度依賴 PRN 藥物。