A patient with head injury has clear nasal drainage. What is the most appropriate nursing action?

• A. Check the nasal drainage for glucose with a Dextrostik or Testape.
• B. Obtain a specimen of the fluid and send for culture and sensitivity.
• C. Have the patient blow the nose and then check the nares for redness.
• D. Take the patient's temperature to determine whether a fever is present.

Answer: (C)

When nasal drainage follows head injury, the priority is to determine whether the fluid is cerebrospinal fluid (CSF) or just mucus. CSF leakage poses a risk for meningitis, so identifying it early guides safer management.

A simple bedside test to distinguish CSF from nasal secretions is to check the drainage for glucose using a Dextrostix or Testape. CSF contains glucose, whereas typical nasal mucus does not. A positive glucose test strongly suggests a CSF leak, prompting appropriate precautions (such as avoiding nose blowing or nasal suctioning, vigilant neuro checks, and notifying the physician for further management).

Obtaining a culture and sensitivity would be unnecessary as an initial step unless infection is suspected after confirming CSF leak. Taking the patient’s temperature can help monitor for fever, but it does not determine whether the drainage is CSF. Blowing the nose isn’t a diagnostic tool and could potentially worsen a CSF leak, so it isn’t the best immediate action.