A client recently fractured his spinal cord at the C3 level and is at

A client recently fractured his spinal cord at the C3 level and is at great risk for developing pneumonia primarily because the:

1. Resulting paralysis immobilizes him, and secretions will increase in his lungs
2. Innervation to the phrenic nerve is absent, preventing chest expansion
3. Resulting abnormal chest shape disallows efficient ventilatory movement
4. Trauma decreases the ability of his red blood cells to carry oxygen

ANSWER

ANS: 2
Cervical trauma at C3 to C5 can result in paralysis of the phrenic nerve, preventing chest expan-sion. Although the increase in lung secretions as a result of immobility is a risk factor, the client’s greatest risk is related to the level of his fracture. There is no mention of an abnormal chest shape. This client’s greatest risk for developing pneumonia is related to the level of his fracture. If the client were anemic as a result of blood loss from trauma, his oxygen-carrying capacity of blood would be decreased. There is no mention of excessive blood loss, nor would this place him at great risk for developing pneumonia.