What physical sign would indicate a distended bladder in a postpartum client?

The presence of a distended bladder in a postpartum client is indicated by the fundus being 3 cm above the umbilicus. After childbirth, the uterus begins to involute, and the fundus should be located at or below the level of the umbilicus within the first few days postpartum. If the fundus is felt above the umbilicus, it suggests that the bladder is distended and pushing the uterus upwards. This can hinder uterine involution and may lead to complications such as hemorrhage.

The other responses do not effectively indicate a distended bladder. For example, if the fundus is at the level of the umbilicus, it suggests a normal involution posture. Voiding 200 mL every hour does not provide conclusive evidence of bladder distension; the volume can vary widely among individuals and does not directly correlate with bladder fullness. Lastly, a fundus that is perfectly midline is typically a sign of proper positioning and uterine return to its normal size and location, which is not indicative of bladder distention. Thus, the correct understanding lies in recognizing the anatomical position of the fundus in relation to the umbilicus as a direct sign of bladder status postpartum.