— 心理社會完整性 · EASY · MCQ —
一位 25 歲患有恐慌症的病人出現心悸、呼吸困難及瀕死感。護理師應優先採取何種介入措施？
A 25-year-old client with a history of panic disorder reports sudden palpitations, shortness of breath, and a sense of impending doom. Which intervention is the priority for the nurse?
- AInstruct the client to breathe into a paper bag指示個案對著紙袋呼吸
- BStay with the client and provide a calm, safe environment✓ 正解陪伴個案並提供安靜、安全的環境
- CPerform a thorough physical assessment to rule out cardiac issues進行詳細的身體評估以排除心臟問題
- DAdminister an as-needed dose of alprazolam給予處方劑量的阿普唑侖（alprazolam）
— Explanation · 中文詳解 —
恐慌發作時，病人的焦慮感達到極致，護理師提供冷靜、安全的氛圍（Stay with the client）能給予病人心理支持與安全感，是穩定情緒的首要步驟。A 現已不建議使用紙袋呼吸以防低氧；C 藥物非第一優先；D 評估雖重要，但需在病人情緒穩定後再進行，以免增加焦慮。
During a panic attack, the nurse's priority is to stay with the client and provide a calm, safe environment to reduce anxiety and ensure safety. While assessment and medication are important, establishing a therapeutic presence is the initial step to stabilize the client's emotional state before addressing physiological needs or conducting further evaluations.
✦ 台美臨床差異
美方護理師更強調以陪伴作為首要介入；台灣臨床常規則偏向先給予鎮靜藥物以求快速緩解症狀。