Visual Analogue Scale andNumerical Rating Scale - Essay Example

?Pain-Related Essay Based On Case Study Patient A 35 years old young male presented in the clinic with right wrist pain resulted from lifting heavy objects 3 weeks ago. On pain VAS, a score of 4 on midday, increasing to 8 after daily life activities; and shooting on radial deviation, otherwise dull or vague throughout the day. Visual Analogue Scale (VAS) According to Waltz, Strickland, Lenz and Faan (2010), Visual analog scales (VAS) are used to measure the intensity of pain after injury. In addition, the visual analog scale can help physicians determine the magnitude of individual’s sensations as well as subjective feelings. In rare cases, VAS is used to measure patient, relative strength of their attitudes and opinions about stimuli and the rate at which they engage in specified behaviors, such as adherence to a therapeutic regiment. Visual analog scores are used to measure pain intensity in patients. The scale has a 10-point numerical rating scale (NRS). The scale rates pain on a scale from (0-10) a scale of 10 is the worst pain that a patient can undergo (Peacock and Peacock, 2010). Numerical rating scale (NRS) Source: (McDowel, 2006) In the above diagram, my patient can be said to have below moderate pain at midday (score of 4). However, the pain increases to near worst possible pain at scale of 8 after daily life activities. The scale ensures that functional activity score of the patient is measures. Functional activity scores refer to activity related score. The patient is asked to engage in activities related to their painful area. Patients can also be asked to increase the nervous system mechanism. For instance, patients can be required to take a deep breath, or move affected leg or arm. Range of Motion (ROM) According to Quinn (2010), the movement of joints from full flexion to full extension is referred to as range of motion. Ever joint in human beings has a normal range of motion. Importantly, range of motion ranges from one individual to another. The stretching of muscles, tendons, and ligaments, enables joints to have a balanced range of motion. To determine pain, the nurse will measure the range of motion by the use of a goniometer. The measurement is recorded in degrees from the starting position. Injuries are the main reasons that can reduce the range of motion, swellings and tissue damage can also lead to reduced range of motion. To the patient, range of motion is relevant. The patient is asked to perform range of motion duties. Range of motion must be regained for the faster rehabilitation of the injury (Quinn, 2010). Patient description On examination, mild swelling and tenderness over radial collateral ligament were identified. End range radial deviation and midway ulnar deviation are painful. The nurse is expected to monitor the patient when they are performing the chosen activities and score A, B or C. A- The patient actions are not affected by pain B- - mild limitation of the activity by pain C- Severe limitation of the activity by pain Nervous System Mechanisms The patient is expected to increase nervous system actions by engaging in regular, and gentle stretching exercises. The exercises should be directed by a qualified physician. Nervous system activities enable the patient to prevent joint stiffness. Stretching will help the patient to exercise contractile and non-contractile soft tissues. In addition, stretching can help the muscles to resume the normal resting length (Pathak, 2011). Muscle pain increases when patients are asked to increase the intensity of exercise. In addition, the duration, in which the exercise is performed results to increased pain. This shows the reason behind pain at scale 8 after daily life activities. The pain is as a result of tears in the fibers that are present in the nervous system. The small nerve cells increase the pain signal to the central nervous system due to the registered tears thereby leading to high levels of pain. Tears are often microscopic; however, the pain experienced is often high. This is due to muscle contractions, especially when force is exerted by the muscles as the patient engages in normal life duties. Consequently, the high level of pain also arises when nervous system muscles go through the stress. Micro-tears are the result achieved after muscle stress. Inflammation on the muscles leads to pain and aches. In most cases, pain can be increased on injuries after undergoing vigorous exercises (Pathak, 2011). The increased pain in the patient (scale of 8) is particularly due to increased activity in the nervous system as a result of normal life duties or exercise. Management plan Hot pack or heat pack Hot pack ensures that the injury on the arm of the patient is prevented from developing further swellings. In particular, an ice pack can be used. The ice park should be heated and should contain a liquid with high heat. In addition, the heated ice pack may also contain a gel. Consequently, a heating pad can be applied to the injury. This heating pad will start heating when the patient starts the crystallization process. Pain-free range of motion exercise Range of motion exercises will ensure that the patient prevents stiffness to the joint. In addition, range of motion exercise enables the patient to prevent any other deformities as well as keep the affected joint flexible (Soehnlein, 2004). The patient should be instructed to move the affected joint (arm) in certain directions. Range of motion will be guaranteed when the patient is made to perform regular and gentle exercises. These exercises should be directed by a qualified professional. The prevention of joint stiffness is the main reason behind range of motion exercises (Gomez, 2010). Range of motion exercise, especially “stretching” helps the contractile and non contractile tissues to regain their normal length. Collagen, and elastic fibers such as; ligaments, and joint capsule lead to tissue lengthening. Tissue lengthening is normally affected by tissue deformation after injuries. However, caution should be exercised when performing the stretching exercise to avoid damaging the tissues further. Regular and periodic stretching should be performed to allow healing and remodeling (Family-friendly-fun.com, 2012). References Family-friendly-fun.com (2012), Range of Motion (ROM) Exercises Are Done to Preserve or Improve Flexibility and Mobility of the Joints, retrieved on 22nd September, 2012, from: http://www.family-friendly-fun.com/therapy/range-of-motion.htm Gomez, T (2010), Pain Free Range of Motion, retrieved on 22nd September, 2012, from: http://www.livestrong.com/article/115536-painfree-range-motion/ Mcdowel, I (2006), Measuring Health: A Guide to Rating Scales and Questionnaires, New York: Oxford University Press. Pathak, S (2011), Aches and Pain from Exercise, retrieved on 22nd September, 2012, from: http://www.livestrong.com/article/539127-aches-pains-from-exercise/ Peacock, J and Peacock, P (2010), Oxford Handbook of Medical Statistics, New York: Oxford University Press. Quinn, E (2010), what is range of motion? Retrieved on 22nd September, 2012, from: http://sportsmedicine.about.com/od/glossary/g/ROM_def.htm Quinn, E (2011), Muscle Pain and Soreness after Exercises, retrieved on 22 September, 2012, from: http://sportsmedicine.about.com/cs/injuries/a/doms.htm Soehnlein, K (2004), the pain of Gain, retrieved on 22nd September, 2012, from: http://www.metroweekly.com/domestic_partner/health/?ak=893 Waltz, C., Strickland, L., Lenz, E and Faan, R (2010), Measurement in Nursing and Health Research, New York: Springer Publishing Company. Read More