A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?

Choice A rationale Following cochlear implant surgery, clients should consume soft foods to minimize the mechanical stress and pressure on the surgical site near the ear and jaw. Chewing hard or crunchy foods involves significant movement of the temporomandibular joint and surrounding muscles, which can cause pain or potentially displace the newly implanted internal components. A soft diet reduces discomfort and protects the integrity of the incision during the initial healing phase of the first few days. Choice B rationale Washing the hair 24 hours after surgery is generally contraindicated because the surgical incision must remain dry to prevent infection and promote proper healing. Most postoperative protocols require the head dressing to remain intact and the site to stay dry for at least 48 to 72 hours, or until the surgeon provides specific clearance. Introducing water and shampoo too early increases the risk of bacterial contamination in the mastoid area where the implant is situated. Choice C rationale Resuming a regular exercise routine immediately after surgery is dangerous due to the risk of increased intracranial pressure and physical trauma to the implant site. Strenuous activity, lifting heavy objects, or bending over can lead to bleeding, swelling, or displacement of the internal electrode array. Patients are typically advised to avoid vigorous physical activity for several weeks to ensure the internal receiver-stimulator is securely seated in the temporal bone and the incision is healed. Choice D rationale Lying on the back is not the specific positional requirement; rather, the client is usually instructed to avoid lying on the affected side. Sleeping on the side of the cochlear implant can cause excessive pressure on the surgical site, leading to pain, impaired circulation to the flap, or displacement of the device. Elevating the head of the bed or lying on the non-operative side is preferred to reduce postoperative edema and protect the sensitive surgical area.