A nurse is reinforcing preoperative teaching with a client who is scheduled for retinal detachment repair. Which of the following instructions should the nurse include in the teaching?

Choice A rationale Applying cool compresses is not a standard preoperative instruction for retinal detachment. While cool compresses can reduce localized edema or discomfort in some ocular conditions, they do not address the primary structural issue of the retina separating from the underlying choroid layer. Management focuses strictly on preventing further detachment through activity modification. In fact, placing any unnecessary pressure or weight on the globe of the eye, even a light compress, is generally avoided during this period. Choice B rationale While an eye patch is often used on the affected eye to provide protection and reduce movement, patching both eyes is not a universal preoperative requirement and can cause significant anxiety or disorientation for the client. The primary goal is to minimize ocular excursions. By covering the affected eye, the client is less likely to track objects, but keeping the unaffected eye open allows the client to maintain some level of environmental awareness and safety while following other movement restrictions. Choice C rationale Lying down as much as possible is too vague and does not account for the specific positioning required to keep the retina in place. The client may be instructed to maintain a specific head position based on the location of the retinal tear to allow gravity to help the retina settle against the pigment epithelium. Simply lying flat without regard to head orientation might actually exacerbate the detachment if the tear is located in a position where gravity pulls it further away. Choice D rationale Restricting head movement is a critical preoperative intervention to prevent the retinal detachment from enlarging. Excessive or jarring movements of the head can cause the vitreous humor to shift, potentially pulling the sensory retina further away from the vascular choroid. This stabilization is vital because the retina relies on the choroid for its blood supply and oxygen; further separation increases the risk of permanent vision loss before the surgical repair can be successfully completed.