— 心理社會完整性 · MEDIUM · MCQ —
一位失智症長者出現躁動與日落症候群，護理師應優先採取哪項措施？
An elderly patient with dementia is agitated and sundowning. Which intervention should the nurse prioritize?
- AUse physical restraints to ensure safety使用身體約束以確保安全
- BPlace the client in a quiet, softly lit room✓ 正解將病人安置在安靜、燈光柔和的房間
- CReorient the client to the date and time向病人重新導向日期和時間
- DAdminister a PRN sedative給予處方備用鎮靜劑
— Explanation · 中文詳解 —
日落症候群（Sundowning）常因傍晚的光線變化、疲勞或環境混亂誘發。最佳護理策略為環境控制，提供柔和光源與安靜空間以減少感官過載，而非直接使用藥物或約束。過度要求失智症病人進行現實導向（Reorientation）往往會增加其挫折感與躁動。
The priority intervention for sundowning is to reduce environmental stimuli by placing the client in a quiet, softly lit room. This approach addresses the underlying triggers of agitation without relying on pharmacological sedation or physical restraints, which can worsen symptoms. Reorientation may also increase frustration in clients with advanced dementia.
✦ 台美臨床差異
美國護理機構嚴格控管約束使用（Restraint-free policy）；台灣在健保評鑑下雖也推動減約束，但臨床實務上約束比例仍偏高。