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

Choice A rationale Postoperative care for retinal detachment focuses on preventing increased intraocular pressure which can jeopardize the surgical repair. Lifting heavy objects initiates a Valsalva maneuver that spikes ocular pressure and potentially displaces the retina again. Limiting weight to less than 15 pounds or 6.8 kilograms is a standard safety precaution. Patients must avoid strenuous activities, bending at the waist, or straining during bowel movements to ensure the internal tamponade effectively holds the retina in place during healing. Choice B rationale Positioning is specific to the location of the retinal tear and the type of internal tamponade used, such as a gas bubble. If a gas bubble was injected, the patient often needs to maintain a prone or face-down position, not face-up, to ensure the bubble floats against the detachment site. Remaining supine for two weeks is generally incorrect as it may cause the bubble to displace and potentially lead to cataracts or increased pressure against the iris. Choice C rationale Driving is strictly prohibited within the first 24 hours due to the lingering effects of anesthesia and blurred vision from dilating drops or surgical trauma. Most patients must wait until their visual acuity is assessed at a follow-up appointment and until depth perception is restored. Resuming driving so early is dangerous because the surgical eye is typically patched or shielded, significantly reducing the peripheral field of vision and spatial awareness necessary for operating a vehicle safely. Choice D rationale Contact lenses cannot be resumed within 48 hours because the cornea and conjunctiva require significant time to heal from surgical incisions and manipulation. Inserting a lens introduces a high risk of bacterial infection and mechanical irritation to the surgical site. Most surgeons require patients to wait several weeks before wearing contacts, usually until the inflammatory response has subsided and the integrity of the ocular surface is fully restored to prevent complications like endophthalmitis or corneal abrasions.