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sundown effect.

9. Agitation

a. Assess the precipitant of the agitation.
b. Reassure the client.
c. Remove items that can be hazardous
when the client is agitated.
d. Approach the client slowly and calmly
from the front, and speak, gesture, and
move slowly.
e. Remove the client to a less stressful
environment; decrease excess stimuli.
f. Use touch gently.
g. Do not argue with or force the client to
do something.

Box 65-1
Criteria for General Anxiety Disorder

▪ Excessive anxiety and worry about several events or activities for more than 6
months
▪ Inability to cope with anxiety
▪ Anxiety associated with three (or more) of the following symptoms for more
than 6 months:
1. Feeling restless or on edge
2. Easily tired
3. Poor attention span
4. Irritability
5. Muscle tension
6. Difficulty sleeping (insomnia, difficulty falling or staying asleep)
▪ Anxiety causes significant distress or impaired ability to work or maintain
relationships
▪ No concurrent substance use or misuse
▪ No underlying medical cause
▪ Not explained by another mental health problem

From American Psychiatric Association: Diagnostic and statistical annual of
disorders, ed 5, Washington, DC, 2013.

Box 65-2

Interventions for Post-traumatic Stress Disorder

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