Follow east, north, south, then head to Uruguay, east (5)
I believe the answer is:
ensue
'follow' is the definition.
(ensue can mean to follow or happen as a result)
'east north south then head to uruguay east' is the wordplay.
'east' becomes 'E' (synonyms).
'north' becomes 'n' (abbreviation).
'south' becomes 'S' (abbreviation).
'then' says to put letters next to each other.
'head to' indicates taking the first letters.
The initial letters of 'uruguay east' is 'ue'.
'e'+'n'+'s'+'ue'='ENSUE'
(Other definitions for ensue that I've seen before include "Leading directly to" , "Transpire" , "Follow subsequently" , "Happen afterwards as a result" , "Befall" .)