Question

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, "Why do my child's fingertips look like that?" The nurse bases a response on the understanding that clubbing occurs as a result of:

1) Increased blood flow to the fingertips
2) Decreased blood flow to the fingertips
3) Inflammation of the fingertips
4) Nerve damage in the fingertips

Answer 1

Clubbing of the fingertips in a child with Tetralogy of Fallot is due to chronic hypoxia, caused by mixed blood flow from structural heart defects that lead to decreased oxygen saturation in the extremities.

Step-by-step explanation:

The parent's observation of their 1-year-old child's clubbed fingertips is related to congenital heart disease, specifically the condition known as Tetralogy of Fallot, which affects normal blood flow and oxygenation. Clubbing of the fingertips happens due to chronic hypoxia, which is a reduced level of tissue oxygenation. In Tetralogy of Fallot, this occurs because of a combination of four heart malformations that result in mixed blood flow, where oxygen-poor blood from the right ventricle enters the systemic circulation, including the fingertips.

The most correct answer to the question of why the child's fingertips are clubbed is:

1. Decreased blood flow to the fingertips

This decreased oxygen circulation leads to the characteristic clubbing. As for Tetralogy of Fallot, it includes ventricular septal defect, pulmonary infundibular stenosis, overriding aorta, and right ventricular hypertrophy. These abnormalities can lead to symptoms such as low blood oxygen saturation, dyspnea, and cyanosis, which is the most common cause of blueish discoloration following birth.