Proper diagnosis?

It all depends on what your assessment data showed. Both diagnoses have specific criteria. Does this pateient have any of the criteria of them? Did you read the definition of each diagnosis?

the pathogenesis is needed to determine the related factor (cause) of the problem. however, it is the actual symptoms that the patient has that determine what the actual problem is because the symptoms are the evidence proving the existence of the problem.

if you have a dead body with a knife protruding from the chest you have a murder--not an embezzlement. the evidence is the dead body with the knife protruding from the chest. the related factor (pathogenesis, cause) of this murder might be that the victim didn't pay off the loan shark who he owed $100,000 to, so the loan shark killed him. that's a reason for the murder. murder r/t money owed to loan shark aeb dead body with knife through heart.

what you are looking for is reasons for impaired swallowing or ineffective airway clearance. but do either or both of these problems exist? determine that first because you don't seem sure of that. do you have mucus, food or both plugging up the pharynx? then, why?

what are the patient's symptoms? the symptoms are listed with each diagnosis in the taxonomy (i listed links to the taxonomy for these two diagnoses below). so, are ideas for related problems (reasons for the problems to have occurred)

impaired swallowing (has to do with difficulty moving food from the mouth through the pharynx and esophagus and to the stomach) impaired swallowing:

• oral phase impairment: lack of tongue action to form bolus; weak suck resulting in inefficient nippling; incomplete lip closure; pushing of food out of mouth; slow bolus formation; falling of food from mouth; premature entry of bolus; nasal reflux; inability to clear oral cavity; long meals with little consumption; coughing, choking, or gagging before a swallow; abnormality in oral phase of swallow study; piecemeal deglutition; lack of chewing; pooling in lateral sulci; sialorrhea or drooling
  
• pharyngeal phase impairment: altered head position; inadequate laryngeal elevation; food refusal; unexplained fever; delayed swallow; recurrent pulmonary infections; gurgly voice quality; nasal reflux; choking, coughing, or gagging; multiple swallows; abnormality in pharyngeal phase by swallowing study
  
• esophageal phase impairment: heartburn or epigastric pain; acidic-smelling breath; unexplained irritability surrounding mealtime; vomitus on pillow; repetitive swallowing or ruminating; regurgitation of gastric contents or wet belches; bruxism; nighttime coughing or awakening; observed evidence of difficulty in swallowing (e.g., stasis of food in oral cavity, coughing, or choking); hyperextension of head, arching during or after meals; abnormality in esophageal phase by swallow study; odynophagia; food refusal or volume limiting; complaints of "something stuck"; hematemesis; vomiting

ineffective airway clearance (has to do with removing mucus from the pharnyx so the person can breathe) ineffective airway clearance:

• dyspnea; diminished breath sounds; orthopnea; adventitious breath sounds (rales, crackles, rhonchi, wheezes); cough, ineffective or absent; sputum production; cyanosis; difficulty vocalizing; wide-eyed; changes in respiratory rate and rhythm; restlessness

does that help?