— 心理社會完整性 · EASY · MCQ —
一名 25 歲患有廣泛性焦慮症的個案因心悸、呼吸急促與瀕死感至診所就診，護理師應優先採取何種處置？
A 25-year-old client with a history of generalized anxiety disorder presents to the clinic with reports of heart palpitations, shortness of breath, and a fear of dying. Which intervention is the priority for the nurse?
- AAdminister an as-needed benzodiazepine給予按需使用的苯二氮平類藥物
- BPerform a comprehensive physical assessment進行全面的身體評估
- CEncourage the client to identify the source of anxiety鼓勵病人找出焦慮的來源
- DInstruct the client to breathe slowly with the nurse✓ 正解指示病人與護理師一起緩慢呼吸
— Explanation · 中文詳解 —
面對急性焦慮症狀，首要任務是減輕生理上的過度換氣與恐慌反應。帶領個案進行緩慢呼吸能有效降低交感神經活性，恢復平靜。其他選項如給藥需醫囑且非首要，探討原因應在個案情緒穩定後進行，物理檢查雖重要但在急性發作時需先穩定情緒。
The priority intervention for a client experiencing a panic attack is to help reduce physiological arousal and hyperventilation. Guiding the client through slow, deep breathing is the most effective immediate strategy to restore calmness before addressing underlying causes or administering medication.
✦ 台美臨床差異
美台護理師均強調急性期穩定情緒，但美國對照護過程中的主動引導較積極，台灣臨床常先仰賴藥物控制。