Certified Pediatric Emergency Nurse (CPEN) Practice Exam

The presence of clear fluid draining from the nose or ears is a significant concern in a child who has sustained a head injury as it may indicate a cerebrospinal fluid (CSF) leak. This situation suggests a possible skull base fracture, which poses serious risks, including infection, such as meningitis, and potentially severe neurological damage.

The clear nasal or ear drainage, known as rhinorrhea or otorrhea respectively, can signify that the protective barrier of the brain has been compromised, allowing for the leakage of CSF outside the body. It’s crucial to assess this symptom promptly, as it may require surgical intervention and close monitoring in a hospital setting to prevent complications.

While swelling above the eye, bruising around the eyes, and severe headache with vomiting are concerning symptoms that can occur in head injuries, they are not as immediately indicative of a serious and critical complication as a CSF leak. Swelling and bruising may represent localized hematomas, and although severe headache and vomiting can suggest increased intracranial pressure or concussion, a CSF leak necessitates urgent evaluation and management due to the associated risks.