The VERY BEST advice - is to HAVE KNOWLEDGE of the area BEFORE making the move! If you scout the area and like it - THEN "Go for It!"... and this is not a week at the Hilton in Montevideo!, get out and see the country, talk to the natives, and experience the cultures and areas - DONT JUST HANG AROUND WITH GRINGOS!
Uruguay is an exceptionally easy country to adapt to, don't try to remake the country into "where you came from", if you do, why not stay where you are?
I would say if you like the rural life in Iowa, like it was 30 years ago, you'll love Uruguay.
I have extensively traveled all of Mexico , Central and South america and found Uruguay one of the best!
There is a super info site, www.trekamericas.net, which gives free advice for Uruguay and B rasil...Happy travels, Norman Yelland

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I'm an American who has lived the last 4 years in Argentina and (now) Uruguay.

When moving abroad you not only have to know that it will be different but allow (or force yourself) to be excited about that very prospect. How much culture shock you'll have depends a lot on how much you've lived abroad, if you're with someone or alone, etc...but I would highly recommend that you study the language before you come and plan to take an immersion language course when you get here as part of your acclimation/orientation plan. There are 3 or 4 good Spanish language schools here in Montevideo where you can take 2-4 hours a day/5 days a week from U$80-200 dollars. Not only will a course like this help you get a good working foundation under you...but it will give you something constructive to do, and allow you to meet others~local people and visitors like yourself, which will mitigate the effects of feeling at a loss/culture shock.

Go out and explore. (Use your Spanish.) Montevideo is a European-style capital city with a lot to do...cafes, great restaurants, beach front walks IN the city, music, dance (tango), theater...etc...all for half of what you'd spend in the U.S. or Western Europe.

Learning some of the language is the single best way to turn what is unfamiliar and disorienting into something exciting and fun.

The most complex and, at first, the most troublesome part of moving to Uruguay was simply assembling all the necessary paperwork to open bank accounts, arrange an apartment 'guarantee', etc., but by doing your homework before you come (contact some people who live here) these minor hassles are easily surmounted.

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These are the main things I'd share:

It depends where you live in Uruguay. If you're living in a high-rise apartment in Pocitos your level of culture shock will be a bit less than if you lived out in the countryside.

Absolutely learn Spanish. You can live in an English bubble just fine but it's very isolating. Do not leave your home without a small dictionary with you.

If you're a guy remember these two words: ladies first. Into the elevator, into a bus, whatever. If you go first you're going to hear about it :)

Getting established with local ID, banking etc. can seem to be a giant task. Put it this way - don't expect you're going to be able to do everything to start your immigration file in a week or even three. Don't expect that you'll be able to get five or six things done in a day. The pace is much slower relative to elsewhere.

The two most important things to keep in mind about visiting government offices are this: 1) try to be there BEFORE they open. 2) Don't let your exasperation show. :)

Be careful with your nest egg. When you get a house or apartment you generally are getting just the walls and the windows. Setting up house might be more expensive than you expect. You will almost certainly need the services of a plumber, an electrician and a locksmith all in the first week or two. Be VERY certain that the electrical installation is properly grounded - especially your hot water heater.

Consider at the outset whether it's your goal to have 100% of the creature comforts (hot water in the kitchen or air conditioning in the bedroom for example) that you had where you previously lived. It may be more expensive than you anticipated to do those things. Especially with air conditioning the cost is quite a bit more than the price of the unit from the store! You will almost certainly be paying UTE (electric utility) a one-time fee to upgrade the amount of "potencia" you can draw without causing the main breaker to trip.

Have a local friend arrange the services for the locksmith, electrician, etc. You can certainly call and do this yourself but when they hear your accent you will pay more.

If you live in an apartment building without a "portero" (doorman) consider carrying a small flashlight on your keychain.

Think twice before you rent or buy a place with a "claraboya" (skylight). All the heat will rapidly escape from the area underneath it during winter. They are also difficult to secure.

When you're homesick for ethnic food like Indian, Thai or Chinese it's a bit of an adventure to figure out how to make it yourself. You will find the selection of spices in the supermarkets isn't quite up to the job. "Casa Singer" on 18 de julio will likely have all of them, although you should figure out what the spice is called in Spanish. Casa Singer also sells locally-made peanut butter - "manteca de mani." It's cheaper than the US$5 small jars of imported peanut butter sold at Tienda Inglesa @ Montevideo Shopping.

The locals have a love-hate relationship with ANTEL. I found the level of service to actually be quite good. Dedicado not so much.

If you live in a rural area (as I did for awhile) it's a very different experience from the city. Your neighbors will be quite curious about you, put it that way. They may ask lots of personal questions. Think before you answer because it's pretty likely it'll get repeated many times over. Our elderly neighbors were very "chusma." (gossipy)

If you live in a rural area having an outside dog is a good idea because it will bark when anyone approaches.

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