Care Plan Help...Please

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

Blue

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!

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!

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/2050. dental CARE AND THE DEMENTIA 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!

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.