مريض في اليوم الثالث بعد احتشاء أمامي يشتكي ألماً حاداً في الصدر يزيد مع النفس العميق والاستلقاء، ويخف عند الجلوس والانحناء للأمام. حرارته ٣٧٫٩. ماذا يتوقع الممرض أن يسمع؟

On day 3 after an anterior MI, a client reports sharp chest pain that worsens with deep breaths and lying flat and eases when sitting forward. Temperature is 37.9 °C. What does the nurse expect to hear?

1. An S3 with crackles at both lung bases
2. A scratchy pericardial friction rub
3. A loud S4 when the client lies on his left side
4. A new apical systolic murmur radiating to the axilla

Answer: B) A scratchy pericardial friction rub. Positional pain eased by leaning forward days after an MI suggests pericarditis, whose hallmark is a friction rub. A new murmur would raise concern for papillary muscle rupture.