Corning Community College

Nurse Education Department

Health & Sciences Division
Spring 2013
NURS 2992-001/Fluids & Electrolytes
(CRN 89901)
Syllabus
Gail Ropelewski-Ryan MS, RN

N308~962-9314~ryan@corning-cc.edu~Office hours posted on door

Revised
1/13

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Student Withdrawal Policy / Last Day to Drop

If for any reason a student must withdraw from this course, it is the students responsibility to do so by submitting an online drop form
through MyCCC. A grade of W will be assigned if the withdrawal occurs before March 24, 2013, the official drop date for this course, and
a grade of F thereafter. If a student simply stops attending rather than officially withdrawing, he or she will receive a grade of F for the
course. The instructor may drop a student for non-attendance.
Academic Honesty Policy
The act of academic dishonesty is one in which a student is trying to gain an unfair academic advantage or is avoiding actions required by
a course, which have been designated to improve some aspect of the students education. Knowingly and willfully aiding or collaborating
with a student in the violation of an Academic Honesty policy, even if not personally committing any violation is considered academic
dishonesty.
Plagiarism occurs when a person presents anothers ideas, information, words, artwork, films, music, graphs, data or statistics as if they
were his or her own creation. Plagiarism is a form of theft and is cheating. When a person copies material from a published source, such
as a periodical, encyclopedia, or book, or downloads a passage from an Internet source and presents that information without proper
documentation (reference or quotation) in a paper or project, then that person has committed plagiarism.
If a violation of this policy has occurred, the instructor will conduct an investigation. The result of this investigation may be a failing grade
on the assignment, failing grade for the course, or expulsion from the class and/or the College.
Students with Disability Information
Students with learning, physical, or psychological disabilities who wish to receive accommodations for this course must contact the Office
of Student Disability Services in Room M152 in the Commons Building on the Spencer Hill Campus at 607-962-9262) or at sds@corningcc.edu. Students are required to self-identify by making a formal request for services, and to provide current documentation that reflects the
nature of the disability. Reasonable accommodations in the classroom will be provided for students with appropriately documented
disabilities. Confidentiality will be maintained at all times.
Class Cancellation / Inclement Weather
Class cancellations by the instructor will be posted via an announcement sent directly to your student email account. Cancellations due to
inclement weather will be posted on the CCC website and the main page of MyCCC. It is the students responsibility to check these
sources on a regular basis.
Text
Fluid & Electrolytes Made Incredibly Easy, Lippencott, 5th edition
Grading
1. Quizzes 35%
2. Study Guides 20%
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3. Final Exam 45% must be completed on April 19th (on campus open note test)
A 95-100%

C 75-70%

A- 90-94%

D 74-70%

B+ 89-86%
B 80-85%
All quizzes & exams are open book. You may use any source to answer the quiz questions. A hard copy of the quiz must be turned into
my mailbox by Noon of the day specified (There will be no exceptions). The final exam is comprehensive and will be administered Friday,
April 19th. You may bring your study guide and note cards with you to the exam which will consist of multiple choice, short answer, and
short essay.
Quizzes are open book, but you must do them on your own. No collaboration. Remember copying verbatim from any source constitutes
plagiarism.
If there is a short _______, or it specifies to list, one or two words is sufficient. ALL other questions must be answered in complete
sentences. Spelling & grammar will be taken into consideration.

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Quiz #1
(Based on Fluid & Electrolytes Made Incredibly Easy chapters 1-4 & 11 and MedCom Video Normal Fluid & Electrolyte Balance)
1.

2/3 of bodily fluid is _____________. 1/3 is ______________.

2.

Fluid loss occurs form the:

________________
________________
________________
________________

3.

Daily urinary output is approximately _________________.

4.

The amount of fluid commonly taken in & excreted daily is _____________.

5.

Extracellular fluid is found in 2 places: _________________

_________________

6.

Fluid is also found in the: _______________________

_______________________
_______________________

7.

Name:

Cations

Anions

______

______

______

______

______

______

______

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8.

Define osmosis:

_________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
9.

Define diffusion:

_________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________

10.

Define active transport:

__________________________________________________

__________________________________________________________________________
__________________________________________________________________________

11.

An example of an isotonic solution is _________________

12.

What is plasma colloid osmotic pressure? _________________________________________

___________________________________________________________________________

13.

Name 3 hormones that effect fluid output then describe how each works
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

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14.

Identify the function of various electrolytes and their normal values (ie: normal pH = 7.35-7.45)
Na+

Cl-

Ca++

K+

PO4- -

HCO3

Mg+ +
15.

Identify systemic impact of prolonged acidosis on the human body:

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16.

Identify systemic impact of prolonged alkalosis on the human body:

17.

Identify 3 Chemical buffers: __________________

__________________
__________________

18.

Lungs excrete acid in the form of _________________________.

19.

Which IV solutions are used for:

a. gastric fluid loss ________________
b. dehydration _______________
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c. shock ________________
d. hypernatremia _________________
e. DKA ___________________
20.

Hypotonic solutions should not be used for patients with _____________________________

__________________________________________________________________________.

21.

Compare and contrast respiratory alkalosis versus metabolic acidosis:

22.

Compare & contrast metabolic versus respiratory acidosis:

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Turn in by Feb. 28

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Quiz 2
(Chapters 5 & 6)
Match the descriptions in Column A with the appropriate electrolyte condition in Column B
Use more than 1 letter for each # if applicable
Column A

a. Hypernatremia

b. Hyponatremia

c. Hyperkalemia

d. Hypokalemia

Column B

1.

caused by use of some diuretics

2.

caused by excess salt intake

3.

assess patient on Digoxin therapy

4.

causes postural hypotension

5.

give normal saline IV (NaCl 0.9%)

6.

may cause muscle cramps and spasticity

7.

treat with IV 5% D/W

8.

nurse uses water

9.

give Kayexalate

10. above 5.5 meq/L

11. dialysis can be used to treat
12. corticosteroids cause
13. for extremely high levels IV insulin & glucose
are used

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Turn in by Mar. 28

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Quiz 3
(Chapters 7, 8, 9, 10)
Match the descriptions in Column A with the appropriate electrolyte condition in Column B
Use more than 1 letter for each # if applicable
Column A

a. Hypercalcemia

Column B

1. causes neuromuscular depression with

diminished reflexes

b. Hypocalcemia

2. causes neuromuscular irritability

c. Hypermagnesaemia

3. caused by prolonged immobility

d. Hypomagnesaemia

4. caused by antacids and laxatives containing

aluminum

e. Hyperphosphatemia

5. observe urine for renal stone

f. Hypophosphatemia

6. give aluminum hydroxide

g. Hypercholoremia

7. assess for signs of hypoxia

h. Hypochloremia

8. usually occurs with sodium imbalance

9. less than 95 meq/L
10. give Fleets Phosho-soda of Calcitonin
11. Dialysis can be used to treat

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Turn in by Mar. 28

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Quiz #4

1. Hydrostatic pressure, which pushed

fluid out of the capillaries, is opposed by
colloid osmotic pressure, which involves:

2. When a persons blood pressure drops,

the kidneys respond by:

reduced rennin secretion.

the pulling power of albumin to

reabsorb water.
b

an increase in ADH secretion.

aldosterone production.

secreting renin.
producing aldosterone.
slowing the release of ADH.
increasing urine output.

3. The main extracellular cation is:

4. Hypertonic solution cause fluids to

move from the:

calcium.

potassium.

magnesium.

sodium.

interstitial space to the intracellular space.

intracellular space to the extracellular

space.

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5. Extravasation of I.V. fluid is associated

with administration of which solution?

extracellular space to the intracellular

space.

extracellular space to the interstitial space.

Hypertonic fluid

D5W

An antineoplastic

Normal saline solution

6. The nurse enters the room of the

a
patient diagnosed with congestive heart
failure. The patient lying in bed gasping
b
for breath is cool and clammy, and has
buccal cyanosis. Which intervention would c
the nurse implement first?
d

7. The nurse is assessing the patient

diagnosed with congestive heart failure.
Which signs/symptoms would indicate that
the medical treatment has been effective?

Sponge the patients forehead.

Obtain a pulse oximetry reading.
Take the patients vital signs.
Assist the patient to a sitting position.
a The patients peripheral pitting
edema has gone from 3+ to 4+.
b The patient is able to take the

radial pulse accurately.

c The patient is able to perform
activities of daily living without dyspnea.
d The patient has minimal jugular

vein distention.

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8. The health-care provider has ordered

an angiotensin-converting enzyme (ACE)
inhibitor for the patient diagnosed with
congestive heart failure. Which discharge
instructions should the nurse include?

a
Instruct the patient to take a
cough suppressant if a cough develops.

Teach the patient how to prevent

orthostatic hypotension.
b

Encourage the patient to eat

bananas to increase potassium level.
c

d
Explain the importance of taking
medication with food.

9. The nurse has written an outcome goal

demonstrates tolerance for increased
activity for a patient diagnosed with
congestive heart failure. Which
intervention should the nurse implement to
assist the patient to achieve this outcome?

10. The patient with pneumonia has the

following arterial blood gases: pH 7.33,
PaO2 94, PaCO2 47, HCO3 25. Which
intervention should the nurse implement?

Measure intake and output.

Provide two (2)-g sodium diet.

Weigh patient daily.

Plan for frequent rest periods.

a

Administer sodium bicarbonate.

Administer oxygen via nasal

cannula.
c

Have the patient cough and deep

breathe.
d
Instruct the patient to breathe in
a paper bag.

11. When caring for the patient with

Administer a respiratory

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hypoxia and hypercapnia, which

intervention should the nurse implement
first?

treatment.
b

Assess the patients pulses.

Encourage the patient to breath

slowly.
Assess the patients capillary
refill time.
d

12. Which nursing interventions should

the nurse implement for the patient who
has a respiratory failure? Select all that
apply.

Administer oxygen via ventimask.

Assess the patients lung sounds.

Encourage the patient to cough

and deep breathe.
c

d
Monitor the patients pulse
oximeter reading.
e

13. Which statement made by the patient

admitted with electrolyte imbalance from
frequent cathartic use demonstrates an
understanding of the discharge teaching?

Force fluids.

a
In the future I will eat a banana
every time I take the medication.

I dont have to have a bowel

movement every day.
b

I should limit the fluids I drink

with my meals.
c

d
If I feel sluggish, I will eat a lot of
cheese and dairy products.

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14. The patient diagnosed with AIDS is

experiencing voluminous diarrhea. Which
interventions should the nurse implement?
Select all that apply.

Monitor diarrhea, charting

amount, character, and consistency.
a

Assess the patients tissue turgor

every day.
b

c
Encourage the patient to drink
carbonated soft drinks.

Weigh the patient daily in the

same clothes and at the same time.
d

e
Assist the patient with a warm
sitz bath PRN.

15. Electrolyte imbalances that are

caused by GI fluid loss include all of the
following except:

16. Systemic symptoms of GI fluid loss

include

hypokalemia

hyponatremia

hypochloremia

hypophophatemia

altered mental status.

bradycardia.

cool moist skin.

decreased hematocrit.

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17. The patient is diagnosed with ARF.

Which laboratory values are most
significant for diagnosing ARF?

18. The patient diagnosed with ARF has a

serum pH of 7.08. Which collaborative
treatment would the nurse anticipate for
the patient?

BUN and creatinine.

WBC and hemoglobin.

Potassium and sodium.

Bilirubin and ammonia level.

Administer a phosphate binder.

b
Administer IV sodium
bicarbonate.
c

Assess the patient for leg

cramps.
d

19. The patient with ESRD is placed on

fluid restriction of 1500 milliliters per day.
On the 7 a.m. to 7 p.m. shift the patient
drank an eight (8)-ounce cup of coffee, 4
ounces of juice, 12 ounces of tea, and 2
ounces of water with medications. What
amount of fluid can the 7 p.m. to 7 a.m.
nurse give to the patient?
20. The patient has been vomiting and
has had numerous episodes of diarrhea.
Which laboratory test should the nurse
monitor?

Prepare the patient for dialysis.

________________________________

Serum calcium

Serum phosphorus

Serum potassium

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Serum sodium

Turn in by April 11
Study Guide (Chapter 5-10)
Imbalance

Causes of Imbalance

Signs/Sx

Hyponatremia

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Treatment (and what do

you do if the treatment
doesnt work)

Nursing Intervention

Hypernatremia

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Imbalance

Causes of Imbalance

Signs/Sx

Hypokalemia

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Treatment (and what do

you do if the treatment
doesnt work)

Nursing Intervention

Hyperkalemia

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Imbalance

Causes of Imbalance

Signs/Sx

Hypocalcemia

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Treatment (and what do

you do if the treatment
doesnt work)

Nursing Intervention

Hypercalcemia

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S 2013 NURS 2992 26

Imbalance

Causes of Imbalance

Signs/Sx

Hypomagnesaemia

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Treatment (and what do

you do if the treatment
doesnt work)

Nursing Intervention

Hypomagnesaemia

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Imbalance

Causes of Imbalance

Signs/Sx

Hypochloremia

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Treatment (and what do

you do if the treatment
doesnt work)

Nursing Intervention

Hyperchloremia

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Imbalance

Causes of Imbalance

Signs/Sx

Hypochloremia

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Treatment (and what do

you do if the treatment
doesnt work)

Nursing Intervention

Hyperchloremia

Turn in by April 11
Study Guides
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This is an example of what I want:

Disorder

Heart Failure

Imbalances caused by this disorder

Hypo/Hypervolemia

Nursing Actions (must relate to

Rationale (there should be a

specific imbalance in Column #2)

great deal of detail in this section. I

need to know that you understand
why you are assessing, monitoring,
administering, & teaching)

Assess

-uncontrolled lt sided heart failure

results in pulmonary edema, rt
sided peripheral edema

-edema (pulmonary & peripheral)

-may be indicative of right sided HF

-liver enlargement
-tachycardia may indicate fluid
volume overload
-vital signs

Monitor

-decreased cardiac output can

negatively impact the kidneys
(output reflects kidney function)

I&O
-weight is the most sensitive
indicator of fluid retention

Weight

-Nat & K+ levels can drop due to

diuretics & potentiate digoxin toxicity

-to decrease fluid volume overload

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Electrolytes

-to prevent hypokalemia

Administer
diuretics
-find out what patient knows
compliance will keep the patient out
of the hospital
K+ supplements

Electrolyte imbalances

Teach
about prescribed medications

Acidosis/Alkalosis

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Study Guides
Imbalances

Nursing Actions

Respiratory Failure

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Rationale

S 2013 NURS 2992 36

Imbalances

Nursing Actions

Excessive GI fluid loss

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Rationale

S 2013 NURS 2992 38

Imbalances

Nursing Actions

Renal Failure

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Rationale

S 2013 NURS 2992 40

Imbalances

Nursing Actions

Burns

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Rationale

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