Care Plan Help...Please

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    Hi I need help with my care plan! I have done all of my assessments and come up with 15 abnormal findings for my patient. We are required to have a 3 part nursing diagnosis for each finding. I am having a hard time finding a nursing diagnosis for teeth grinding. My patient is 85y/o c/o teeth grinding. She has recently (within the last month) noticed that she is grinding her teeth constantly. During my observations I noticed that the grinding was worse when she was focusing or having a hard time with a task. She has a hard time getting dressed, she has shoulder pain, tires easily, feels weak and refuses to use adaptive equipment, this is where I noticed the grinding was worst. I've already done diagnosis r/t the shoulder pain, tires easily, feels weak and refuses to use adaptive equipment. I just really don't understand what diagnosis to use for the teeth grinding.
    I was thinking Dressing self-care deficit r/t weakness aeb teeth grinding while dressing.Or perhaps the teeth grinding is stress induced and it should be ineffective coping r/t loss of function aeb teeth grinding during ADLs. (does that even make sense?) Or maybe it's an extrapyramidal symptom to a med?
    I am so confused! Help is greatly appreciated!
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  3. 7 Comments so far...

  4. 0
    What about anxiety? Or ineffective coping? Or something along those lines. I would probably look through the psychosocial nursing dx's.

    Blue
  5. 0
    Quote from hope4ccns
    Hi I need help with my care plan! I have done all of my assessments and come up with 15 abnormal findings for my patient. We are required to have a 3 part nursing diagnosis for each finding. I am having a hard time finding a nursing diagnosis for teeth grinding. My patient is 85y/o c/o teeth grinding. She has recently (within the last month) noticed that she is grinding her teeth constantly. During my observations I noticed that the grinding was worse when she was focusing or having a hard time with a task. She has a hard time getting dressed, she has shoulder pain, tires easily, feels weak and refuses to use adaptive equipment, this is where I noticed the grinding was worst. I've already done diagnosis r/t the shoulder pain, tires easily, feels weak and refuses to use adaptive equipment. I just really don't understand what diagnosis to use for the teeth grinding.<BR>I was thinking Dressing self-care deficit r/t weakness aeb teeth grinding while dressing.Or perhaps the teeth grinding is stress induced and it should be ineffective coping r/t loss of function aeb teeth grinding during ADLs. (does that even make sense?) Or maybe it's an extrapyramidal symptom to a med?<BR>I am so confused! Help is greatly appreciated!
    <BR>...sounds like teeth grinding should be your supporting data, not part of your nursing diagnosis...ineffective coping, anxiety, knowledge deficit. Does she have dementia, alzheimers? is she grieving? depressed? does she communicate? why won't she use the adaptive equipment? Fear? You can go all kinds of ways with this...hope i've helped, and not confused you more.
  6. 0
    She has Parkinson's. Could it be a manifestation of that? I don't see it as a symptom in my books but tremors increase with concentration could teeth grinding be a motor function affected by PD? She doesn't use the adaptive equipment because she believes it makes it harder. I used deficient knowledge r/ lack of information for that. I was thinking along the anxiety lines as well. Thanks all for the advice so far!
  7. 0
    I am so glad that you are basing this on what the patient needs......the assessment. But, I need to know more about your patient to make a suggestion. Teeth grinding is typically found in osteoporosis, depression, stress and anxiety, osteopenia, pain.

    Other than Parkinson's .....What is her history? What are her co -morbidities? There are also some drugs that have this as a side effect........ It is a common side effect of Fosamax, Paxil, Effexor, Zoloft, Zometa.

    This may help you...http://www.alzbrain.org/pdf/handouts...IA PATIENT.pdf

    Teeth grinding - Symptom Checker - check medical symptoms at WrongDiagnosis
    Last edit by Esme12 on Nov 21, '12
  8. 0
    Quote from Esme12
    I am so glad that you are basing this on what the patient needs......the assessment. But, I need to know more about your patient to make a suggestion. Teeth grinding is typically found in osteoporosis, depression, stress and anxiety, osteopenia, pain.Other than Parkinson's .....What is her history? What are her co -morbidities? There are also some drugs that have this as a side effect........ It is a common side effect of Fosamax, Paxil, Effexor, Zoloft, Zometa.

    This may help you...http://www.alzbrain.org/pdf/handouts...IA PATIENT.pdf

    Teeth grinding - Symptom Checker - check medical symptoms at WrongDiagnosis
    I don't see grinding as a side effect to any of her meds. She was admitted for dysphagia, secondary dx or history are GERD, 1st degree AV block, osteoarthritis, and osteopenia.
    Thanks!
  9. 0
    I don't know if teeth grinding is a symptom of Parkinson's but I've noticed that a lot of my Parkinson's pts tend to do that.
  10. 0
    If you open the PDF document it talks about teeth grinding. It can be a tartive dyskensia type phenomenon and evidence of parkinsons.

    http://www.alzbrain.org/pdf/handouts...%20PATIENT.pdf


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