During preoperative teaching to a patient scheduled for a transsphenoidal hypophysectomy for treatment of a pituitary adenoma, the nurse includes which instruction?

A. Position flat in bed with sandbags at head: After a transsphenoidal hypophysectomy, the patient’s head is typically elevated to reduce intracranial pressure and minimize the risk of cerebrospinal fluid (CSF) leakage. Lying flat with sandbags would increase ICP and is contraindicated. B. Cough vigorously and deep breathe every 2 hours: Forceful coughing and straining increase intracranial pressure and can disrupt the surgical site, leading to CSF leakage or bleeding. Patients are usually instructed to avoid coughing, sneezing, or straining postoperatively. C. Take replacement growth hormone for a few months: Hormone replacement depends on which pituitary hormones are affected and is individualized. Some patients may require lifelong hormone therapy, not just a few months, and preoperative teaching focuses on surgical precautions rather than post-op medication timing. D. Report clear drainage from nose: Clear, watery nasal drainage may indicate CSF leak, a serious postoperative complication that increases the risk of meningitis. Prompt reporting allows early assessment and intervention, making this a critical teaching point for patient safety.