Exemplar 6.A the concept of F/E: 1. Define the following terms: Intracellular fluid Extracellular fluid Intravascular fluid Interstitial fluid Cation Anion Osmosis Solutes Solvent Osmolality Osmolarity Tonicity Osmotic pressure Colloid osmotic pressure (oncotic pressure) Diffusion Filtration Hydrostatic pressure Active transport 2. What is the average daily fluid intake for an adult? What are the sources of intake? 3. Explain the factors that stimulate water intake through the thirst mechanism. 4. What are the four routes of fluid output? What is the average daily fluid output for an adult? 5. Describe how volume and composition of body fluids is regulated. Discuss body systems involved and hormonal influences. 6. Electrolyte (Include normal value), What does it do/what system does it effect? How is it regulated? a. Potassium b. Sodium c. Magnesium d. Calcium 7. What are three ways a nurse can evaluate fluid and electrolyte status without a providers order? 8. What are the key components of a focused assessment to determine fluid and electrolyte balance? 9. Explain labs and diagnostics that specifically measure fluid and electrolyte balance. 10. Describe lifespan considerations r/t f/e balance: a. Very young b. Very old c. pregnant Exemplar 6.B F/E Imbalances: 11. What is the difference between fluid volume deficit (FVD) and dehydration? 12. Describe the pathophysiology and etiology of FVD and how is it classified. 13. Describe the specific types of dehydration: a. Isotonic dehydration b. Hypotonic dehydration c. Hypertonic dehydration 14. What is third spacing? 15. What are the multisystem effects of fluid volume deficit? 16. Discuss lifespan considerations for children and older adults with fluid volume deficit. 17. List priority nursing diagnoses, expected patient outcomes, and related nursing interventions for an individual with a fluid volume deficit. 18. List 3 teaching points when caring for an individual with fluid volume deficit. 19. Describe the pathophysiology and etiology of fluid volume excess (FVE). 20. Can fluid volume excess, hypervolemia, and edema be used interchangeably? Why or why not? 21. What is edema? 22. Describe how the following clinical conditions cause edema: a. Increased blood hydrostatic pressure b. Decreased blood colloid osmotic pressure c. Increased interstitial fluid osmotic pressure d. Blocked lymphatic drainage 23. What are the multisystem effects of fluid volume excess? 24. Compare the assessment findings with fluid imbalance: a. Blood pressure (Fluid deficit and Fluid excess) b. Heart rate (Fluid deficit and Fluid excess) c. Pulse amplitude (Fluid deficit and Fluid excess) d. Respirations (Fluid deficit and Fluid excess) e. Jugular vein (Fluid deficit and Fluid excess) f. Edema (Fluid deficit and Fluid excess) g. Skin turgor (Fluid deficit and Fluid excess) h. Output (Fluid deficit and Fluid excess) i. Urine specific gravity (Fluid deficit and Fluid excess) j. Weight (Fluid deficit and Fluid excess) 25. D.

1. Exemplar 6.A the concept of F/E:
1. Define the following terms: Intracellular fluid Extracellular fluid Intravascular fluid Interstitial
fluid Cation Anion Osmosis Solutes Solvent Osmolality Osmolarity Tonicity Osmotic pressure
Colloid osmotic pressure (oncotic pressure) Diffusion Filtration Hydrostatic pressure Active
transport
2. What is the average daily fluid intake for an adult? What are the sources of intake?
3. Explain the factors that stimulate water intake through the thirst mechanism.
4. What are the four routes of fluid output? What is the average daily fluid output for an adult?
5. Describe how volume and composition of body fluids is regulated. Discuss body systems
involved and hormonal influences.
6. Electrolyte (Include normal value), What does it do/what system does it effect? How is it
regulated? a. Potassium b. Sodium c. Magnesium d. Calcium
7. What are three ways a nurse can evaluate fluid and electrolyte status without a providers
order?
8. What are the key components of a focused assessment to determine fluid and electrolyte
balance?
9. Explain labs and diagnostics that specifically measure fluid and electrolyte balance.
10. Describe lifespan considerations r/t f/e balance: a. Very young b. Very old c. pregnant
Exemplar 6.B F/E Imbalances:
11. What is the difference between fluid volume deficit (FVD) and dehydration?
12. Describe the pathophysiology and etiology of FVD and how is it classified.
13. Describe the specific types of dehydration: a. Isotonic dehydration b. Hypotonic dehydration
c. Hypertonic dehydration
14. What is third spacing?
15. What are the multisystem effects of fluid volume deficit?
16. Discuss lifespan considerations for children and older adults with fluid volume deficit.
17. List priority nursing diagnoses, expected patient outcomes, and related nursing interventions
for an individual with a fluid volume deficit.
18. List 3 teaching points when caring for an individual with fluid volume deficit.
19. Describe the pathophysiology and etiology of fluid volume excess (FVE).
20. Can fluid volume excess, hypervolemia, and edema be used interchangeably? Why or why
not?
21. What is edema?
22. Describe how the following clinical conditions cause edema: a. Increased blood hydrostatic
pressure b. Decreased blood colloid osmotic pressure c. Increased interstitial fluid osmotic

2. pressure d. Blocked lymphatic drainage
23. What are the multisystem effects of fluid volume excess?
24. Compare the assessment findings with fluid imbalance: a. Blood pressure (Fluid deficit and
Fluid excess) b. Heart rate (Fluid deficit and Fluid excess) c. Pulse amplitude (Fluid deficit and
Fluid excess) d. Respirations (Fluid deficit and Fluid excess) e. Jugular vein (Fluid deficit and
Fluid excess) f. Edema (Fluid deficit and Fluid excess) g. Skin turgor (Fluid deficit and Fluid
excess) h. Output (Fluid deficit and Fluid excess) i. Urine specific gravity (Fluid deficit and
Fluid excess) j. Weight (Fluid deficit and Fluid excess)
25. Discuss fluid restriction guidelines.
26. What should be included when teaching an individual about a low sodium diet?
27. List priority nursing diagnoses, expected patient outcomes and related nursing interventions
for an individual with a fluid volume excess.
28. Complete the following chart for the electrolytes most commonly evaluated in chronic
disease: Electrolyte (Include normal value), Signs of deficiency? Treatment for deficiency? Signs
of excess? Treatment for excess? a. Potassium b. Sodium c. Magnesium d. Calcium
Exemplar 6.C Chronic Kidney Disease
1) Compare and contrast how primary kidney disease (i.e. glomerulonephritis) and various
systemic conditions (i.e. hypotension & hypertension) can impact kidney function.
2) Analyze risk factors what increases the likelihood of a person developing CKD?
3) What are the early manifestations of CKD?
4) How much slower than normal is GFR by the time a person first experiences these
signs/symptoms?
5) What are some typical assessment findings a nurse might expect related to the effects of
uremia on body systems? a. Neurologic b. Respiratory c. Cardiovascular d. GI e. Urinary f.
Electrolytes & acid-base balance g. Skin h. Muscles/joints i. Hematologic j. Immunity
6) Describe labs and diagnostic tests related to the evaluation of kidney function.
7) Provide rationale for the following anticipated medication orders r/t CKD: a. Furosemide b.
Lisinopril c. Calcium supplements d. Kayexalate e. Iron supplements
8) Explain dietary recommendations for someone with CKD.
9) Compare and contrast the risk and benefits of the medical management of end stage renal
disease (ESRD): a. Hemodialysis b. peritoneal dialysis c. kidney transplant
10) Provide etiologies for the following nursing diagnosis r/t CKD: a. Ineffective renal tissue
perfusion b. Fluid volume excess c. Impaired skin integrity d. Imbalanced nutrition: less than
body requirements e. Electrolyte imbalance f. Confusion g. Activity intolerance h. Impaired gas
exchange i. Impaired mobility j. Risk for infection k. Ineffective management of therapeutic
regimen

3. 11) Provide rationale for each of the following nursing interventions r/t CKD: a. Monitor for
dysrhythmias b. Obtain daily weights c. Assess lung sounds d. Administer antihypertensives e.
Assess for SOB, tachycardia, dizziness f. Monitor albumin levels g. Provide mouth care h.
Consult with dietician i. Restrict visitors j. Educate patient regarding fluid restriction k.
Administer diuretic l. Provide skin care, include antipruritic lotion m. Hourly rounding