In preparation for cataract surgery, the nurse is to administer prescribed eye drops. The nurse reviews the physician’s orders, expecting which type of eye drops to be instilled?
A. An osmotic diuretic
B. A miotic agent
C. A mydriatic medication
D. A thiazide diuretic
Correct Answer: C. A mydriatic medication
A mydriatic medication produces mydriasis or dilation of the pupil. Mydriatic medications are used preoperatively in the cataract client. These medications act by dilating the pupils. They also constrict blood vessels. Tropicamide is a safe drug used for pupillary dilation prior to a comprehensive eye exam or ocular procedure. Dilation is also necessary for specific intraocular procedures such as cataract surgery to reduce intraoperative complications and for better exposure of the cataract during surgery.
Option A: An osmotic diuretic may be used to decrease intraocular pressure. Osmotic diuretics cause a direct increase in luminal hyperosmolarity in the renal tubules without affecting electrolyte balance, whereas aquaretics are substances that act directly by only affecting the excretion of water.
Option B: A miotic medication constricts the pupil. These medications reduce eye pressure by increasing the drainage of intraocular fluid through the trabecular meshwork. Cholinergics can be used alone or combined with other glaucoma medications.
Option D: A thiazide diuretic is not likely to be prescribed for a client with a cataract. Thiazides are the best first choice for hypertension, as concluded in a recent Cochrane review, and chlorthalidone is the best first-line agent among all the anti-hypertensive compared according to the 2017 American college of cardiology (ACC) hypertension guidelines.
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