If the patient refuses a medication, what should the nurse do? (Select all that apply.)

A) Notify the health care provider: It is essential to inform the healthcare provider if a

patient refuses a medication. This allows for a reassessment of the patient's treatment plan and ensures that any necessary follow-up or adjustments can be made based on the patient's refusal.

B) Determine the reason for refusal: Understanding why a patient refuses medication is crucial. It may be due to side effects, lack of understanding, personal beliefs, or concerns about the medication. Gathering this information can help the nurse address the patient’s concerns and educate them appropriately.

C) Administer the dose when the next dose is due: Administering a medication that the patient has refused would violate their rights and could be considered coercive. The patient has the right to refuse treatment, and the nurse should respect that decision rather than attempt to administer it later without consent.

D) Document the reason for refusal in the patient's health record: Accurate documentation is vital in healthcare. Recording the patient's refusal and the reason for it in their health record ensures continuity of care and provides information for other healthcare team members regarding the patient's preferences and concerns.

E) Mix it in a small amount of their food: This action is inappropriate and unethical. Coercively administering medication without the patient's consent undermines their autonomy and trust in the healthcare system. The nurse should always respect the patient’s right to refuse medication.

A) 16-year-old female, who has had vomiting and diarrhea: While vomiting and diarrhea can lead to dehydration and electrolyte imbalances, this scenario alone does not directly indicate an increased risk of drug toxicity. However, it could affect drug absorption and excretion, so monitoring may be warranted.

B) 65-year-old male, who has been on high doses of antibiotics for 3 weeks: Prolonged use of high doses of antibiotics can increase the risk of toxicity, particularly if the patient has underlying kidney or liver issues. Extended antibiotic use can also disrupt normal gut flora, potentially leading to adverse effects or superinfections.

C) 75-year-old female, who swallowed Caladryl lotion: While ingesting topical medications can pose risks, it does not necessarily indicate a significant risk for systemic drug toxicity unless large quantities are involved. This patient’s risk would depend on the amount ingested and her overall health status.

D) 43-year-old male, who has liver failure: Patients with liver failure are at a heightened risk for drug toxicity because the liver plays a crucial role in drug metabolism. Impaired liver function can lead to accumulation of medications, increasing the likelihood of adverse effects.