A nurse is caring for a child who is having a tonic-clonic seizure and vomiting. Which of the following actions is the nurse's priority?

A. Assess the bowel sounds:

Bowel sounds are not directly related to the assessment of ascites. Bowel sounds are more relevant in assessing gastrointestinal function and peristalsis. While bowel changes could potentially be a sign of complications, monitoring abdominal girth is more specific to tracking ascites.

B. Frequently ambulate child:

While ambulation is important for overall health, it's not a direct assessment method for monitoring ascites. Ambulating a child might have benefits, but it won't provide specific information about the presence or progression of ascites.

C. Weigh child weekly:

Weekly weighing can provide some information about overall fluid balance, but it might not be as sensitive as measuring abdominal girth when it comes to detecting changes in ascites. Additionally, monitoring weight alone might not give insight into the distribution of fluid in the abdominal cavity.

D. Monitor and measure the abdominal girth.

Explanation: The presence of ascites (accumulation of fluid in the abdominal cavity) in a child with nephrotic syndrome could indicate worsening kidney function and fluid balance. Monitoring and measuring the abdominal girth is a reliable way to assess changes in the amount of fluid accumulation over time. An increase in abdominal girth could suggest a worsening condition.

Fluid Requirement (mL/24 hours) = Weight (kg) × Fluid Requirement (mL/kg)

Given that the child weighs 70.4 pounds, we first need to convert this weight to kilograms (1 lb = 0.453592 kg):

Weight in kg = 70.4 lb × 0.453592 kg/lb ≈ 31.89 kg

Now, let's calculate the fluid requirement using the given choices:

A) 1740:

Fluid Requirement = 31.89 kg × 55 mL/kg = 1753.95 mL

B) 134056:

This number is significantly larger than any reasonable fluid requirement and is likely an error.

C) 2:

This value is far too low to represent the fluid requirements of a child.

D) 12:

This value is also too low to represent the fluid requirements of a child.

So, the correct answer is A) 1740 mL. The child's estimated daily fluid requirement would be around 1740 mL in a 24-hour period, based on a weight of 70.4 pounds.