— 心理社會完整性 · MEDIUM · SATA —
一位患有失智症的個案出現「日落症候群」，護理師應包含哪些護理計畫？（選所有適合的）
A nurse is caring for a client with dementia who is experiencing 'sundowning'. Which interventions should the nurse include in the plan of care? (Select all that apply.)
- AIncrease light levels in the room during the late afternoon✓ 正解在下午晚些時候增加房間的光線
- BEncourage frequent daytime naps to prevent exhaustion鼓勵頻繁的白天小睡以預防疲勞
- CProvide structured and consistent daily routines✓ 正解提供結構化且一致的每日常規
- DAdminister PRN sedatives at 4 PM every day每天下午 4 點給予處方備用鎮靜劑
- ELimit complex activities in the late afternoon and evening✓ 正解限制下午晚些時候和晚上的複雜活動
— Explanation · 中文詳解 —
日落症候群常發生於傍晚，應透過環境調整改善。增加光照可緩解混亂；維持固定生活作息能減輕焦慮；避免傍晚進行複雜活動以免過度疲勞。B 錯誤：過多白天午睡會導致夜間睡眠障礙；D 錯誤：不可常規使用鎮靜劑處理症狀，應以非藥物護理為主。
Interventions for sundowning include increasing light levels to reduce shadows, maintaining consistent daily routines for security, and limiting complex activities in the evening to prevent overstimulation. Daytime naps and routine sedatives are not recommended as they can worsen sleep cycles or mask symptoms.
✦ 台美臨床差異
美國強調避免使用鎮靜劑（化學約束），台灣在照護實務上，部分機構仍傾向依醫師處方使用藥物以控制行為問題。