Question

The nurse is assessing a patient with pericarditis. In order to hear a pericardial friction rub, which technique does the nurse use?

a. Place the diaphragm at the apex of the heart.
b. Place the diaphragm at the left lower sternal border.
c. Place the bell just below the left clavicle.
d. Place the bell at several points while the patient holds his or her breath.

Answer 1

To hear a pericardial friction rub in a patient with pericarditis, the nurse should place the diaphragm of the stethoscope at the left lower sternal border, also known as the Erb's Point.

Step-by-step explanation:

The nurse uses a specific technique to auscultate for the presence of a pericardial friction rub, which is a sound made by the rubbing of the heart's pericardial layers against each other. This rubbing can occur when the pericardium (the protective sac around the heart) becomes inflamed, a condition known as pericarditis. To hear a pericardial friction rub, the nurse should:

1. Place the diaphragm of the stethoscope at the left lower sternal border of the patient's chest, also known as the Erb's Point.

This placement allows for the best chance of hearing the distinctive sound of a pericardial friction rub. It is important for the patient to be in a position that brings the heart closer to the chest wall, such as sitting forward and leaning slightly, which may enhance the sound of the rub. The nurse may also ask the patient to hold their breath briefly, as breathing sounds can mask the rub.