A trauma nurse is caring for a patient with an anterior spinal cord injury at the C6 level. What assessment finding would be most concerning?

In the context of an anterior spinal cord injury at the C6 level, the most concerning assessment finding would be increasing work of breathing. This is primarily due to the anatomical and physiological implications of the injury.

The C6 spinal segment is associated with the upper extremities and plays a significant role in breathing mechanics. Injuries at or above this level can impair the function of the diaphragm and intercostal muscles, which are crucial for effective respiration. An increase in the work of breathing suggests that the patient may be experiencing respiratory distress, potentially leading to inadequate ventilation and oxygenation.

Respiratory complications are a significant risk following cervical spine injuries due to the potential loss of motor function and sensation in the respiratory muscles. Therefore, monitoring respiratory status is critical in any patient with a high cervical spinal cord injury. In contrast, the other assessment findings, while important, do not indicate an immediate threat to the patient's respiratory function and overall stability to the same extent that increased work of breathing does.