Which client should a nurse prioritize for referral in a rehabilitation unit for traumatic brain injury?

Prioritizing referral for the client who consistently coughs after drinking liquids is essential due to the risk of aspiration. In patients with traumatic brain injuries, there can be impairments in the swallowing reflex and coordination of the muscles involved in swallowing. This inability to swallow safely can lead to food or liquid entering the airway, increasing the likelihood of aspiration pneumonia, which is a serious and potentially life-threatening complication.

When such a swallowing dysfunction is observed, it indicates a need for immediate evaluation by a speech-language pathologist to conduct a swallowing assessment and to provide interventions for safe feeding practices. This proactive approach helps to reduce complications and promotes better recovery outcomes.

While the other clients present issues that could benefit from various forms of rehabilitation, they do not pose an immediate threat to the client's safety and well-being as the swallowing issue does. A headache, fatigue, and the need for physical therapy are valid concerns, but they are not as urgent as ensuring safe swallowing and preventing aspiration.