A nurse is evaluating morning laboratory values on a group of clients. Which of the following findings indicates a risk for impaired skin integrity?

Choice A reason: Fibrinogen is a clotting factor. A decreased fibrinogen level increases bleeding risk but does not directly impair skin integrity. It is more associated with coagulation disorders rather than wound healing. Choice B reason: Albumin is a protein essential for maintaining oncotic pressure and supporting tissue repair. A decreased albumin level indicates poor nutritional status and is strongly associated with impaired wound healing and increased risk for skin breakdown. Clients with hypoalbuminemia are at higher risk for pressure ulcers and delayed recovery. Choice C reason: Increased bilirubin level indicates liver dysfunction or hemolysis. While it may cause jaundice, it does not directly impair skin integrity or wound healing. Choice D reason: Increased calcium level (hypercalcemia) affects neuromuscular and renal function but does not directly impair skin integrity. It is not a primary risk factor for skin breakdown.