The client is brought to the emergency department after falling off a roof and landing on his back. A T1 spinal fracture is diagnosed. The client's blood pressure is 74/40 mm Hg, pulse is 50/min, and skin is pink and dry. What nursing action is a priority?

Circulation stability

Administration of Intra Venous (IV) normal saline

Explanation: Circulation Stability is achieved by the  Administration of fluids and it is a priority to ensure adequate passage of fluid through the circulatory system or lymphatic system to an organ or a tissue. (Perfusion) this because this presentation is an classic for distributive shock, furthermore there could be loss of innervation from the spine which is likely due to vascular dilation with decreased venous return to the heart.

Neurogenic shock usually occurs in cervical or high thoracic injuries (T6 or higher). Bradycardia. low blood pressure(hypotention), pink and dry from vasodilation are c;assic signs/symptoms of neurogenic shock, distributive shock.

Therefore the nursing action that is of utmost priority is Circulation stability.