The nurse is caring for a client scheduled to receive cyclopentolate HCl preoperatively. Which finding in the client’s history would prompt the nurse to notify the health care provider?

  1. osteoporosis
  2. hypothyroidism
  3. renal insufficiency
  4. cardiac dysrhythmias
Number 4 is correct.
Rationale: Cyclopentolate HCl is a mydriatic medication used to dilate the pupils preoperatively and for eye examinations. Use of mydriatics is contraindicated in clients with cardiac dysrhythmias, as this increases the risk of serious side effects such as tachycardia and hypertension due to systemic absorption. This can lead to stroke, myocardial infarction, and cardiac ischemia, especially in the elderly or those with pre-existing myocardial disease. Osteoporosis, hypothyroidism, and renal insufficiency are not conditions that would contraindicate use of mydriatics.