Final answer:
A history of smoking is a risk factor for impaired wound healing in a client with an open reduction internal fixation of the tibia.
Step-by-step explanation:
In a client with an open reduction internal fixation of the tibia, a history of smoking is a risk factor for impaired wound healing. Smoking causes vasoconstriction, reducing blood flow to the wound and limiting the delivery of oxygen and nutrients necessary for healing. It also impairs the immune response, making the client more susceptible to infections.