A nurse is reviewing the laboratory findings for a client who has idiopathic thrombocytopenic purpura (ITP). Which of the following findings should the nurse expect to be decreased?

A. A friction rub:A friction rub is a sound caused by the rubbing of inflamed pericardial layers and is not classified as a heart sound like S1 or S2. It is unrelated to the sequence of heart sounds.

B. A split second heart sound S₂:A split S₂ occurs during the closure of the aortic and pulmonary valves and is heard after S1, not before.

C. The third heart sound (S3):S3, or the ventricular gallop, occurs shortly after S2 during early diastole and indicates rapid ventricular filling. It is not heard before S1.

D. The fourth heart sound (S4):S4, known as the "atrial gallop," occurs just before S1 during atrial contraction. It is associated with a stiff or hypertrophied ventricle and is often indicative of underlying heart disease, especially in older adults.

A."I will follow a daily diet high in calories and protein": While maintaining adequate nutrition is important, emphasizing a diet high in calories may not be suitable. A balanced diet, including adequate protein, is recommended.

B."I will avoid getting a flu shot": Individuals with emphysema are at an increased risk of respiratory infections, including influenza. Getting a flu shot is generally recommended to reduce the risk of infection and complications.

C. "I will inhale slowly through pursed lips to help me breathe better."
This statement reflects a correct understanding of a beneficial breathing technique for individuals with emphysema. Inhaling slowly through pursed lips can help create back pressure in the airways, preventing them from collapsing and promoting better air exchange in the lungs. This technique can assist in managing shortness of breath and improving overall respiratory function.

D."I will lie on my stomach to practice abdominal breathing every day": While practicing abdominal breathing can be beneficial, lying on the stomach may not be the most practical or comfortable position for this purpose. The emphasis should be on proper breathing techniques, which can be done in various positions, including sitting or standing.