The nurse brings the patient's medications but the patient refuses to take them, stating, "I'll take them later. Right now my stomach feels a little upset. Could you please bring me some crackers?" What is the best action the nurse should take? (Select all that apply.)

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.

A) 1.5: Administering 1.5 mL of Amoxil would provide 37.5 mg of amoxicillin (125 mg per 5 mL translates to 25 mg per mL), which is insufficient to meet the ordered dose of 0.05 g (50 mg). Accurate dosing is essential for effective treatment.

B) 0.5: Giving 0.5 mL would result in only 12.5 mg of amoxicillin, which is significantly below the prescribed dose of 0.05 g. It's crucial to ensure the dose administered aligns with the healthcare provider's orders to achieve the desired therapeutic effect.

C) 2: Administering 2 mL of Amoxil is correct. At a concentration of 125 mg per 5 mL, this dosage provides 50 mg of amoxicillin (2 mL x 25 mg/mL = 50 mg), which meets the prescribed order and ensures proper treatment.

D) 1: One mL would deliver 25 mg of amoxicillin, which is still inadequate compared to the required dose of 50 mg. Proper dosing ensures the medication's efficacy while minimizing the risk of resistance and treatment failure.