The client's family says, "We don't understand what is happening to Dad. He seems better earlier in the day and then in the evening his confusion and agitation really increase."
What is the best explanation by the nurse for what the client is experiencing? 1. Delirium
2. Anxiety
3. Psychosis
4. Sundown syndrome
4. Sundown syndrome
Rationale:
Sundown syndrome, or sundowning, is understood as confused behavior when the environmental stimulation is low. It is seen in clients with delirium and dementia who are institutionalized. The client can become increasingly agitated, disoriented, or even aggressive/paranoid or impulsive and emotional later in the day and at night.
Delirium is a rapid onset type of confusion. Anxiety does not come and go; it is a state of mind. Psychosis is a mental disorder, and this client is not exhibiting signs of psychosis.
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