A nurse is reinforcing discharge teaching with a client who is postoperative following a cataract extraction. Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale Bending at the knees instead of the waist is a crucial instruction to prevent an increase in intraocular pressure. When a client bends over at the waist, head-down positioning significantly increases venous pressure in the head and eyes. Normal intraocular pressure ranges from 10 to 21 mmHg, and spikes in this pressure can rupture delicate surgical sutures or cause vitreous loss. Maintaining the head in an upright position preserves the integrity of the recent cataract extraction. Choice B rationale Aspirin is a salicylate that inhibits platelet aggregation and can increase the risk of intraocular hemorrhage or bleeding at the surgical site. Postoperative pain following cataract surgery should be mild and is typically managed with acetaminophen. Significant pain, especially when described as brow pain, can indicate a dangerous spike in intraocular pressure or acute glaucoma, which is a surgical emergency. The client should report such pain to the surgeon immediately rather than self-medicating with aspirin. Choice C rationale Lifting heavy objects, generally defined as anything over 5 to 10 pounds, is strictly prohibited during the initial healing phase after eye surgery. Straining or lifting increases intrathoracic and intracranial pressure, which directly translates to increased intraocular pressure through the Valsalva maneuver. This pressure can cause wound dehiscence or displacement of the newly implanted intraocular lens. Grocery bags weighing 15 pounds exceed the safe weight limit for most patients recovering from a cataract extraction procedure. Choice D rationale Lying on the operative side is contraindicated because it puts direct pressure on the surgical eye and can increase localized intraocular pressure. Clients are typically instructed to sleep on their back or on the non-operative side to avoid accidental trauma or pressure to the eye while sleeping. This restriction usually lasts for several weeks, not just 24 hours. Sleeping with an eye shield is also required to prevent the client from rubbing or poking the eye during sleep.