What should a nurse do first if noting clear drainage from a client’s nostril after a basal skull fracture?

In the case of clear drainage from a client’s nostril following a basal skull fracture, testing the drainage for glucose is the priority action. This is crucial because clear nasal discharge can indicate the presence of cerebrospinal fluid (CSF), particularly if the drainage is due to a skull fracture that has compromised the protective layers covering the brain.

CSF has a characteristic composition that includes glucose, so a test for glucose levels can help confirm whether the drainage is indeed CSF. Identifying CSF is essential for prompt management since any leakage can lead to severe complications, like meningitis, and may require immediate intervention.

Quick and accurate assessment at this stage is critical, as it informs further actions by the healthcare team. If the drainage tests positive for glucose, it signifies a need to take additional steps to protect the central nervous system and manage the fracture appropriately.