Final answer:
The nurse's priority when caring for a client with a closed traumatic brain injury on mechanical ventilation is to monitor intracranial pressure, as it is critical to prevent further brain injury and facilitate cerebral perfusion.
Step-by-step explanation:
The nurse is planning care for a client who has a closed traumatic brain injury from a fall and is receiving mechanical ventilation. Among the interventions listed, the nurse's priority would be monitoring intracranial pressure (ICP). Monitoring ICP is crucial because the cerebrospinal fluid (CSF) plays a role in protecting the brain and preventing brain ischemia by affecting intracranial pressure and facilitating blood perfusion. Elevated ICP can lead to further brain injury and is a critical parameter to monitor in a patient with traumatic brain injury.
While monitoring for signs of infection, providing nutritional support, and preventing skin breakdown are also important interventions, they do not take precedence over the immediate threat posed by potential increases in intracranial pressure. An increase in ICP can compromise cerebral perfusion and lead to further brain damage or death.