A nurse is reinforcing discharge teaching with a client following a cataract extraction. Which of the following should the nurse include in the teaching?

Choice A rationale Bending at the waist is contraindicated because it increases intraocular pressure by shifting fluid volume and increasing venous congestion in the head and neck. Following cataract extraction, the surgical incision and the newly implanted intraocular lens must remain stable. Elevated pressure can lead to wound dehiscence or displacement of the lens. Patients are taught to keep their head up and use their knees to squat if they must reach for items on the floor. Choice B rationale Removing the eye shield at bedtime is incorrect because the shield is specifically required during sleep to prevent accidental rubbing or poking of the eye. While sleeping, a patient may inadvertently apply pressure to the operative site, which increases intraocular pressure and risks infection or mechanical damage to the delicate surgical site. The shield provides a rigid physical barrier that ensures the eye remains protected from external trauma throughout the vulnerable nighttime hours. Choice C rationale Limiting the use of laxatives is incorrect because straining during a bowel movement, known as the Valsalva maneuver, significantly spikes intraocular pressure. Following eye surgery, maintaining a soft stool consistency is a priority to prevent any internal pressure surges that could compromise the surgical repair. If a patient is constipated, they should be encouraged to use prescribed stool softeners or mild laxatives rather than avoiding them, as the physical act of straining is highly dangerous. Choice D rationale Seeing flashes of light is not an expected finding following a cataract extraction and instead serves as a classic warning sign of retinal detachment. While some mild blurring or scratchiness is common, flashes of light or an increase in floaters indicate that the retina may be pulling away from the back of the eye. This is a medical emergency that requires immediate notification of the surgeon to prevent permanent vision loss in the affected eye.