Page 1978 - Saunders Comprehensive Review For NCLEX-RN

d. Instruct the client to close the eyes
gently, rolling the eyeball in all
directions (increases contact area of
medication to eye).
e. Instruct the client that vision may be
blurred by the ointment.
f. If possible, apply ointment just before
bedtime.
II. Mydriatic, Cycloplegic, and Anticholinergic Medications (Box 57-1)

A. Description

1. Mydriatics and cycloplegics dilate the pupils
(mydriasis) and relax the ciliary muscles
(cycloplegia).
2. Anticholinergics block responses of the sphincter
muscle in the ciliary body, producing mydriasis and
cycloplegia.
3. These medications are used preoperatively or for eye
examinations to produce mydriasis.
4. Mydriatics are contraindicated in glaucoma, cardiac
dysrhythmias, and cerebral atherosclerosis and
should be used with caution in the older client and in
clients with prostatic hypertrophy, diabetes mellitus,
or parkinsonism.
B. Side and adverse effects
1. Tachycardia
2. Photophobia
3. Conjunctivitis
4. Dermatitis
5. Elevated blood pressure
C. Atropine toxicity
1. Dry mouth
2. Blurred vision
3. Photophobia
4. Tachycardia
5. Fever
6. Urinary retention
7. Constipation
8. Headache, brow pain
9. Worsening of glaucoma
10. Confusion
11. Hallucinations, delirium
12. Coma
D. Systemic reactions to anticholinergics
1. Dry mouth and skin
2. Fever
3. Thirst
4. Hyperactivity

1978