Immediate client care for basilar skull fracture should include

• A. Elevate legs and encourage ambulation
• B. Cervical spine immobilization, close neurologic monitoring, and support of ABCs
• C. Administer diuretics to reduce brain pressure
• D. Administer high-dose IV antibiotics immediately

Answer: (B)

When a basilar skull fracture is suspected, the priority is to prevent further injury while maintaining vital functions. The best immediate care includes stabilizing the cervical spine to protect the spinal cord, and ensuring the airway, breathing, and circulation are preserved, all while closely watching the patient’s neurologic status for any changes. This approach addresses the most dangerous risks in trauma—potential spinal injury and evolving brain injury—by preventing movement that could worsen injury, securing the airway, and monitoring for signs of deterioration such as altered consciousness or pupil changes. Elevating the legs and encouraging walking do not address these life-threatening risks and could worsen spinal injury. Diuretics to reduce brain pressure are not routinely used right away in this scenario, and high-dose IV antibiotics are not automatically given unless there is an open fracture or a confirmed CSF leak with infection risk.