A nurse is caring for a client following an open colectomy. Which of the following findings places the client at risk for delayed wound healing?

A. INR 1.1 (0.8 to 1.1): A normal INR indicates proper clotting function and does not increase risk for delayed wound healing. Coagulation status is adequate to support post-surgical recovery. B. Hyperemesis: Persistent vomiting can lead to fluid and electrolyte imbalances, malnutrition, and protein depletion, all of which impair wound healing. Adequate nutrition is critical for collagen synthesis and tissue repair after surgery. C. HbA1c 5.6% (4 to 5.9%): A normal HbA1c indicates good blood glucose control, which supports wound healing. Elevated blood glucose can impair healing, but this client’s level is within normal limits. D. Uncontrolled pain: While uncontrolled pain can affect mobility and stress responses, it does not directly impair the physiological processes of wound healing. Pain management is important but less directly linked to delayed tissue repair than nutritional deficits.