Individuals with a spinal cord injury from C3-C6 have a weak, ineffective cough reflex, which puts them at risk for aspiration pneumonia. They do not have a dry, hacking cough due to suppression of their cough reflex. Bronchoconstriction is associated with asthma; there is no indication this patient has asthma. Kussmaul respirations are deep, rapid respirations associated with acidosis, which is much less likely than aspiration pneumonia.