SIM Scenario Exchange

Fluid and Electrolyte Imbalance

Contributed on July 4, 2022, last updated December 19, 2023.



Sue Coffey RN, PhD, Ontario Tech University, Leslie Graham RN, MN, PhD (c), CNCC, CHSE, CCSNE, Ontario Tech University

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Keith Gregor is a 26-year-old male with a 10-year history of ulcerative colitis resulting in a colectomy 14 months ago and placement of ileostomy. He presented to ER with a 36-hour history of vomiting and increased ileostomy output. He was pale, tachycardic and hypotensive. Bloodwork shows hypernatremia and dehydration. He was given 2 L of NS IV in ER and is admitted to the medical unit with IV NS infusing at 125 mL/hr. He had repeat lab work drawn with results pending.

Learning Objectives:

  1. Identify fluid and electrolyte disturbance based on clinical presentation and laboratory findings to respond to patient condition.
  2. Demonstrate appropriate nursing and collaborative interventions to correct fluid and electrolyte abnormalities to restore homeostasis.
  3. Apply principles of safe medication administration according to regulatory standards.
  4. Communicates effectively to the healthcare team to ensure timely interventions related to evolving data

Simulation Modality:

Virtual gaming simulation / virtual patient


086, CAN-Sim


Coffey S, Graham L. Fluid and Electrolyte Imbalance. Simulation resource published by Simulation Canada; 2022. Available from

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Target Learners






Undergraduate / post-secondary

Fields / Disciplines:


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