一位 25 歲廣泛性焦慮症患者至診所就診，主訴心悸與呼吸困難。護理師應優先採取的措施為何？
A 25-year-old client with generalized anxiety disorder presents to the clinic reporting palpitations and shortness of breath. Which nursing intervention is the highest priority?
- ARemain with the client and maintain a calm, quiet environment✓ 正解留在病人身邊並維持安靜平和的環境
- BAdminister an as-needed benzodiazepine給予按需使用的苯二氮平類藥物
- CInstruct the client to breathe into a paper bag指導病人用紙袋呼吸
- DReview the client's medication compliance history檢視病人的用藥順從性歷史
面對焦慮症狀，護理師的首要任務是提供安全且穩定的陪伴，減輕環境刺激以降低病人的焦慮感。與病人保持安靜的環境能有效幫助個體穩定神經系統，比給藥或處理生理症狀更優先，且紙袋呼吸法在臨床上已不再建議使用，因可能導致缺氧風險。
The highest priority for a client experiencing acute anxiety symptoms is to remain with them and maintain a calm, quiet environment to reduce sensory stimulation. This supportive presence helps de-escalate the anxiety response more effectively than immediate pharmacological intervention or outdated techniques like paper bag breathing. Ensuring safety and emotional stability is the primary nursing responsibility before addressing other factors.
台美護理師皆強調心理支持，但美國更強調護理師在緊急心理諮詢中的獨立角色。