Scenario 2: Pleural Friction Rub A 35-year-old female with a positive history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 5-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.

 

Question:

  1. Because of the result of a pleural friction rub, what does the APRN recognize?

Physical findings in a pleural friction rub include an adventitious breath sound on chest auscultation, which is heard as a harsh, grunting sound during systole and diastole. When examining the patient with a friction rub, the APRN will identify that SLE caused an inflammation of the pericardium resulting in pericarditis (Dein et al., 2019). When the patient was in active lupus, antigen-antibody complexes formed and mediated inflammation of the pericardium. Therefore, the APRN will recognize that the client’s symptoms are caused by pericarditis, which is characterized by fever, dyspnea, tachycardia, and faint heart sounds. Pericardial rub is a common finding on physical exam.

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