What sign would indicate portal hypertension in a client with cirrhosis?

The presence of abdominal distention in a client with cirrhosis is a strong indicator of portal hypertension. Portal hypertension occurs when there is increased pressure within the portal venous system, often due to the scarring (fibrosis) of the liver tissue associated with cirrhosis. This increased pressure can lead to the accumulation of fluid in the abdominal cavity, known as ascites, resulting in noticeable abdominal distention.

In this context, abdominal distention is a clear manifestation of fluid retention and increased pressure in the portal circulation. It signifies that the liver is struggling to manage blood flow and may be unable to synthesize proteins adequately, leading to further complications.

In contrast, flat neck veins typically indicate normal central venous pressure, while specific laboratory values such as hemoglobin levels or platelet counts may not directly correlate with the presence of portal hypertension. For example, while a platelet count may decrease due to hypersplenism associated with portal hypertension, a count of 600,000 mm3 would actually suggest thrombocytosis, which is the opposite of what would be expected in significant portal hypertension. The hemoglobin level mentioned indicates adequate red blood cell mass and does not specifically relate to portal pressure. Therefore, abdominal distention is the most definitive sign of