Which cue would suggest that a patient should not receive a blood transfusion and alternative treatments should be considered?

• A. The client has a history of anemia
• B. The patient is allergic to penicillin
• C. The client is over 65
• D. The client is Jehovah's Witness

Answer: (D)

The main concept is respecting the patient’s right to refuse treatment based on personal beliefs. A patient who is a Jehovah’s Witness is typically opposed to receiving blood transfusions due to religious doctrine. Because of this, if the patient is competent to make decisions, their choice to decline a transfusion should be honored, and the care plan should shift to non-blood management strategies.

In practice, this means confirming the patient’s wishes, providing information about the risks of not receiving a transfusion, and documenting the refusal. Then focus on alternatives to manage anemia or blood loss, such as iron therapy or erythropoietin to boost red blood cell production, volume expanders or crystalloids to maintain circulation, and blood-conservation approaches during procedures. If surgery or a condition would typically require transfusion, coordinating with the medical team on bloodless techniques (like cell-saver technology) and other non-blood options is essential.

The other cues—history of anemia, penicillin allergy, or age—do not by themselves indicate a refusal of transfusion and would not cue the need to consider alternatives based on beliefs.