Final answer:
Bluish or purple nail beds and delayed color return during a blanch test are signs indicating further follow-up is needed due to potential chronic hypoxia. Fungal infections may also require attention.
Step-by-step explanation:
When assessing a client's nailbeds for chronic hypoxia, it's important to look for specific signs indicating inadequate oxygenation. If nail beds appear bluish or purple, this can be a sign of low oxygen saturation. A blanch test can also be performed where a fingernail is depressed, making the nail bed turn white, and once released, the color should return within a second or two. In cases of chronic hypoxia, the return to the normal pink color can be delayed. Additional signs that warrant further follow-up include thickened and yellowish nails, indicating potential fungal infections, which can be more common in toenails due to the warm, moist environment and less blood flow compared to fingernails.