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A patient with cirrhosis admitted for grade II hepatic encephalopathy has received lactulose 30 mL every 6 hours for 24 hours. He has had one formed stool, remains disoriented to time, and has asterixis. His ammonia has fallen from 140 to 118 mcg/dL, and he refuses the next dose because it 'tastes awful.' What should the nurse do?
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