A patient is prescribed Flexeril (cyclobenzaprine) for muscle spasms. Which of the following is the most common side effect that the nurse should educate the patient about?

Choice A reason: This is incorrect. Reviewing the patient’s previous blood glucose levels may not be helpful in determining the correct dose of insulin, as the blood glucose level can fluctuate depending on various factors, such as food intake, activity, stress, and illness. The previous blood glucose levels may not reflect the current insulin needs of the patient¹.

Choice B reason: This is incorrect. No review is not an option before administering insulin, as insulin is a highalert medication that can cause serious harm if given incorrectly. The nurse should always check the patient’s blood glucose level, the insulin order, the insulin type, the insulin dose, the insulin expiration date, and the insulin injection site before giving insulin.

Choice C reason: This is correct. Reviewing the Regular insulin sliding scale for administration in the patient’s electronic medical record is the best action to determine the correct dose of insulin. A sliding scale is a chart of insulin dosages based on blood glucose level and mealtime. It is used to adjust the insulin dose according to the patient’s blood glucose level and insulin sensitivity. The nurse should follow the sliding scale protocol and verify the insulin dose with another nurse before administering it.

Choice D reason: This is incorrect. Reviewing the patient’s previous insulin administration doses may not be helpful in determining the correct dose of insulin, as the insulin dose may vary depending on the patient’s blood glucose level and insulin sensitivity. The previous insulin doses may not reflect the current insulin needs of the patient¹.

Choice A reason: Peak level is the correct term to describe the highest concentration of a drug in the blood after it is administered. Peak level is also known as peak plasma concentration or Cmax, and it reflects the rate and extent of drug absorption. Peak level is influenced by factors such as the route of administration, the dose, the formulation, and the bioavailability of the drug. Peak level is important to monitor for drugs that have a narrow therapeutic range, meaning that there is a small difference between the effective and toxic doses. The nurse should measure the peak level at the appropriate time after the drug administration, and adjust the dose or the frequency as needed to achieve the desired therapeutic effect and avoid adverse effects .

Choice B reason: Halflife is not the correct term to describe the highest concentration of a drug in the blood after it is administered. Halflife is the time it takes for the concentration of a drug in the blood to decrease by 50%. Halflife reflects the rate of drug elimination, which depends on factors such as the metabolism and excretion of the drug. Halflife is important to determine the dosing interval and the time to reach steady state. The nurse should consider the halflife of the drug when prescribing or administering the drug, and avoid drug accumulation or subtherapeutic levels .

Choice C reason: Trough level is not the correct term to describe the highest concentration of a drug in the blood after it is administered. Trough level is the lowest concentration of a drug in the blood before the next dose is given. Trough level reflects the balance between drug absorption and elimination, and it indicates the minimum effective concentration of the drug. Trough level is important to monitor for drugs that have a narrow therapeutic range, meaning that there is a small difference between the effective and toxic doses. The nurse should measure the trough level just before the next dose of the drug, and adjust the dose or the frequency as needed to achieve the desired therapeutic effect and avoid adverse effects .

Choice D reason: Steady state is not the correct term to describe the highest concentration of a drug in the blood after it is administered. Steady state is the condition when the rate of drug administration is equal to the rate of drug elimination, and the concentration of the drug in the blood remains constant. Steady state is usually reached after four to five halflives of the drug, and it reflects the optimal therapeutic level of the drug. Steady state is important to maintain for drugs that have a long halflife or a narrow therapeutic range, meaning that there is a small difference between the effective and toxic doses. The nurse should ensure that the drug is administered at regular intervals and at the appropriate dose to achieve and maintain steady state.