A nurse is obtaining a preoperative medical and surgical history from a client scheduled for a cataract extraction procedure. Which of the following client statements require further investigation by the nurse?

Choice A rationale An incessant cough increases intraocular pressure and puts excessive strain on the surgical site during and after a cataract extraction. Coughing can lead to wound dehiscence or an intraocular hemorrhage. The nurse must investigate this because it might necessitate postponing the procedure to ensure client safety and optimal surgical outcomes. Respiratory infections or chronic coughs are significant contraindications for elective eye surgeries that require a stable, quiet field. Choice B rationale Aspirin is a platelet aggregation inhibitor that increases the risk of bleeding during surgical procedures. Stopping aspirin one week prior to surgery is a standard preoperative instruction to allow platelet function to recover. This statement indicates that the client followed preoperative protocols correctly. Since the client complied with safety measures to reduce hemorrhagic risks, no further investigation is required by the nurse regarding this specific medication management before the eye surgery. Choice C rationale Managing blood pressure medications while fasting for surgery is a common concern for clients. While some providers want specific medications held, others prefer them taken with a small sip of water. The nurse should clarify the specific provider orders, but this statement typically reflects a client trying to adhere to NPO status. It is a common preoperative behavior that requires simple clarification rather than a deep investigation into an unexpected or dangerous physical symptom. Choice D rationale Removing contact lenses before eye surgery is a standard requirement to prevent infection and allow for proper surgical preparation of the eye surface. The client stating they did not put them in shows adherence to preoperative instructions. This is a positive safety action and does not indicate a complication or a need for the nurse to investigate further for potential surgical risks or underlying medical issues that could compromise the cataract procedure.