Nurse Gem is auscultating a client’s chest.
How can the nurse differentiate a pleural friction rub from other abnormal breath sounds?
a- A rub occurs during expiration only and produces a light, popping, musical noise.
b- A rub occurs during inspiration only and may be heard anywhere.
c- A rub occurs during both inspiration and expiration and produces a squeaking or grating sound.
d- A rub occurs during inspiration only and clears with coughing.
Answer C.
The nurse should systematically assess all areas of the abdomen, if time and the client’s condition permit, concluding with the symptomatic area.
Otherwise, the nurse may elicit pain in the symptomatic area, causing the muscles in other areas to tighten. This tightening would interfere with further assessment.
How can the nurse differentiate a pleural friction rub from other abnormal breath sounds?
a- A rub occurs during expiration only and produces a light, popping, musical noise.
b- A rub occurs during inspiration only and may be heard anywhere.
c- A rub occurs during both inspiration and expiration and produces a squeaking or grating sound.
d- A rub occurs during inspiration only and clears with coughing.
Answer C.
The nurse should systematically assess all areas of the abdomen, if time and the client’s condition permit, concluding with the symptomatic area.
Otherwise, the nurse may elicit pain in the symptomatic area, causing the muscles in other areas to tighten. This tightening would interfere with further assessment.