A patient with a spinal cord injury has SpO2 89% and crackles. What is the priority nursing intervention?

A patient with a spinal cord injury has SpO2 89% and crackles. What is the priority nursing intervention?

• A. Turn the patient to the left laying position
• B. Suction the patient
• C. Increase intravenous fluid intake
• D. Have the patient use the incentive spirometer

Answer: (B)

The priority is clearing the airway to improve oxygenation. Low SpO2 with crackles indicates secretions or fluid are impairing gas exchange, and a spinal cord injury often leaves the patient with an ineffective cough. Suctioning directly removes mucus and secretions that are blocking the airways, which can rapidly improve oxygenation and ventilation. Repositioning might help drainage but won’t immediately resolve the airway obstruction. Increasing IV fluids could worsen pulmonary edema or crackles. An incentive spirometer helps prevent atelectasis but won’t quickly relieve existing secretions or hypoxemia in this moment. After suctioning, reassess SpO2 and continue with appropriate respiratory support and evaluation for underlying causes like infection or edema.

The priority is clearing the airway to improve oxygenation. Low SpO2 with crackles indicates secretions or fluid are impairing gas exchange, and a spinal cord injury often leaves the patient with an ineffective cough. Suctioning directly removes mucus and secretions that are blocking the airways, which can rapidly improve oxygenation and ventilation.

Repositioning might help drainage but won’t immediately resolve the airway obstruction. Increasing IV fluids could worsen pulmonary edema or crackles. An incentive spirometer helps prevent atelectasis but won’t quickly relieve existing secretions or hypoxemia in this moment. After suctioning, reassess SpO2 and continue with appropriate respiratory support and evaluation for underlying causes like infection or edema.