The nurse is caring for a patient with pleurisy. When the nurse auscultates the patient's lungs, a friction rub is heard. This friction rub is the result of
•Pleurisy is an inflammation of the parietal pleura that causes pleuritic pain and can be caused by infection, lupus, cancer, or other conditions.
•Pleural effusion may also be seen in some cases, which is an accumulation of fluid in the pleural space. Certain causes of pleurisy, such as lupus and drug-induced pleuritis or tuberculosis pleuritis are more commonly associated with pleural effusion as exudate accumulates between the pleurae. In these cases, the effusion lubricates the pleurae, stopping the friction rub until treatment resolves the source of pleurisy and effusion.
•The friction rub, a classic feature of pleurisy, is caused by serositis, in which the normally smooth surfaces of the parietal and visceral pleurae become irritated and rough with inflammation. As these surfaces rub together, a rough scratching sound can be heard with inspiration and expiration.
•Increased inflammation would contribute to the development of a pleural friction rub.
•Antibiotic therapy may help resolve pleural friction rub by treating the underlying cause of pleurisy if it is due to an infection.
•The patient clearing secretions