Which statement best describes immediate post-craniotomy nursing priorities?

• A. Maintain a fixed neck position at all times.
• B. Place patient in Trendelenburg to improve drainage.
• C. Monitor neuro status and pupils; protect airway; manage head/neck position for venous drainage; monitor drains for infection and CSF leakage.
• D. Avoid any assessment of drainage and infection.

Answer: (C)

After craniotomy, the main focus is to protect the airway and neurological status while ensuring head/neck positioning supports venous drainage and minimizes intracranial pressure, along with careful monitoring of surgical drains for signs of infection or CSF leakage. Regular neuro checks and pupil assessment help detect early deterioration, which is critical in the immediate post-op period. The head should be elevated and kept in a neutral position to promote venous return from the brain and prevent strain on the surgical site; extreme neck positioning or twisting can impede drainage and elevate ICP. Monitoring drains for infection and CSF leakage is essential because early signs of complications can indicate developing problems that require prompt intervention. In contrast, keeping a fixed neck position is not necessary and can hinder drainage; Trendelenburg worsens cerebral edema and ICP and is not used; and avoiding drainage assessment would miss important warning signs.