Question

A female client has clear fluid leaking from the nose following a basilar skull fracture. The nurse assesses that this is cerebrospinal fluid if the fluid:

A. Is clear and tests negative for glucose.
B. Is grossly bloody in appearance and has a pH of 6.
C. Clumps together on the dressing and has a pH of 7.
D. Separates into concentric rings and tests positive for glucose.

Answer 1

The client's cerebrospinal fluid leakage can be identified if the fluid forms concentric rings when dried and tests positive for glucose, indicating a 'halo sign' typically associated with CSF.

Step-by-step explanation:

The female client with clear fluid leaking from the nose following a basilar skull fracture likely has cerebrospinal fluid (CSF) leakage if the fluid 'D. Separates into concentric rings and tests positive for glucose.' This characteristic is known as the 'double ring' or 'halo sign' and the presence of glucose in the clear fluid are indicative of CSF. Normally, CSF is clear and tests positive for glucose due to the glucose it contains. Biochemical constituents of normal CSF include it being watery and having low viscosity, with a specific gravity of 1.003 to 1.008 and an approximate isotonic solution with proteins and glucose. Beta-2 transferrin assay is utilized for its sensitivity and specificity in detecting CSF leakage. A lumbar puncture can confirm the diagnosis by analyzing the CSF for cells, protein, glucose, microorganisms, and other signifiers of nervous system infections or conditions.