Saunders Respiratory Practice

When caring for a client diagnosed with pleurisy, which sign or symptom should the nurse expect?

1. Chronic cough

2. Fever and chills

3. Pleuritic pain during expiration

4. Pleural friction rub

The correct answer is: Pleural friction rub

In the context of pleurisy, the presence of a pleural friction rub is a significant sign to expect. Pleurisy, also known as pleuritis, is an inflammation of the pleurae, the two layers of tissue surrounding the lungs. This inflammation can lead to the visceral and parietal pleura rubbing against each other, especially during breathing movements, which creates a characteristic sound known as a pleural friction rub. The sound is often described as a grating or creaking noise, and it is best heard with a stethoscope during auscultation of the lungs. This finding indicates that the pleural surfaces are inflamed and suggests irritation, which is a hallmark feature of pleurisy. While other symptoms such as fever and chills or pleuritic pain during expiration may also be present due to underlying infection or inflammation, the distinct sound of a pleural friction rub specifically indicates the presence of pleuritis. Consequently, recognizing this sound is crucial for accurate assessment and management of patients with pleurisy.