Friction Rub

Definition

A friction rub is a grating, rubbing, or creaking sound heard on auscultation when inflamed pleural (pleural friction rub) or pericardial (pericardial friction rub) surfaces move against each other.

Types

• Pleural friction rub: Heard with breathing (inspiration and expiration); disappears with breath-holding. Indicates pleurisy, pulmonary embolism, pneumonia, TB.
• Pericardial friction rub: Heard with heartbeat; PERSISTS with breath-holding (indicates pericarditis). Often post-MI (Dressler syndrome), autoimmune, uremia, post-cardiac surgery.

Clinical Significance

Pericarditis can progress to pericardial effusion and cardiac tamponade, a cardiovascular emergency with Beck's triad (hypotension, JVD, muffled heart sounds). Pleurisy often accompanies serious pulmonary disease.

Nursing Interventions

Document timing, location, and relationship to breathing/heartbeat. Administer NSAIDs for pericarditis (unless post-MI; aspirin preferred). Monitor for tamponade signs. Position upright and leaning forward for comfort.

NCLEX Relevance

Pleural rub: stops with breath-hold. Pericardial rub: persists.