For a patient diagnosed with spinal cord injury, which nursing diagnosis is considered priority?

• A. Fluid Volume Deficit
• B. Impaired Physical Mobility
• C. Ineffective Airway Clearance
• D. Altered Tissue Perfusion

Answer: (C)

Airway management is the immediate concern in spinal cord injury because preserving ventilation and the ability to clear secretions is essential for survival. When the injury disrupts neural control of the respiratory muscles, especially with higher-level injuries, the patient may have shallow breathing and a weak cough. Secretions can accumulate, leading to atelectasis, pneumonia, or airway obstruction. That makes impaired airway clearance the most urgent risk to address, since without an open, functional airway and adequate ventilation, other problems like fluid volume deficit, impaired mobility, or tissue perfusion cannot be effectively managed.

In practice, assess for signs of airway compromise (rapid or shallow breathing, decreased breath sounds, use of accessory muscles, ineffective cough, audible secretions) and intervene with measures to facilitate airway clearance (positioning, suctioning as needed, humidified air, chest physiotherapy, incentive spirometry as appropriate).