An older client with confusion has a prescription to receive a blood transfusion. Which of the following actions should the nurse take to obtain consent?

Question

1. Request the client's family member or next of kin sign the consent.
2. Withhold the blood transfusion until the client's mental status improves.
3. Administer the blood transfusion since a signed consent form is not necessary.
4. Explain the transfusion, help the client sign the consent, and administer the transfusion.

Answer 1

1. Request the client's family member or next of kin sign the consent.

Explanation: 1. The nurse who finds a patient lacking the capacity to provide consent, as in the case of a confused patient, must still obtain consent from a family member or next of kin, unless it was a life-threatening situation, in which the medical staff can then proceed in the client's best interest, which is considered implied consent.
2. Withholding the transfusion until the client is no longer confused delays the treatment and may result in harm to the client.
3. A blood transfusion is considered a specialized procedure and requires a separate informed consent form be signed.
4. Explaining the treatment to a confused client and then assisting the client to sign the consent does not meet the test of capacity for consent (understanding, reasoning, problem solving, and communicating the decision).