The patient has rhinorrhea after a head injury. What action should you take?

• A. Pack the nares with sterile gauze.
• B. A loose collection pad may be placed under the nose.
• C. Suction the drainage with an inline suction catheter.
• D. Obtain a sample for culture.

Answer: (B)

Recognizing a CSF leak after head injury is critical because it signals a skull base fracture and a risk for meningitis. The best nursing action is to keep the nasal drainage unobstructed while providing a safe way to observe and collect it. A loose collection pad under the nose allows drainage to be monitored and measured without blocking the nasal passages or forcing material back into the sinuses. This approach minimizes infection risk and avoids manipulating the leak.

Packing the nares with gauze is not appropriate because it can obstruct drainage, trap CSF, and raise infection risk. Suctioning the drainage with an inline catheter could introduce bacteria and irritate the nasal mucosa, potentially worsening the leak. Obtaining a culture sample isn't an immediate management step for a suspected CSF leak and could increase infection risk without addressing the underlying issue.