A nursing home resident with Alzheimer's disease appears extremely distressed after breakfast. On which understanding does the nurse base intervention?
a. This is part of the sundowning syndrome associated with Alzheimer's disease.
b. The patient could quickly become more anxious and dysfunctional.
c. The patient needs an increase in antipsychotic medications.
d. The patient would benefit from external stimuli and diversionary activities.
ANS: B
Stress may increase dysfunctional behaviors. Sundowning is confusion that occurs at sundown, not in the morning; it has not been validated. Increasing medications is inappropriate if simple environment alterations can keep the patient calm. Stimuli make dysfunction worse, not better.
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