3 Lesson Plans for Teaching CNAs and PCTs “Measuring Fluid Intake”

Measuring fluid intake can be one of the most frustrating lessons to teach for BOTH CNA and PCT students AND instructors. 

Once you factor in the different nurse aide program settings (facility based, college/trade school, career & technology center), the topic becomes tricky as well.

Having taught in all three settings, I can honestly say I’ve taught this topic a little differently in all 3. 

Facility based programs have limited access to technology and a limited budget. 

I’ve actually taught a nurse aide program in a utility closet transformed into a tiny classroom containing chairs and one hospital bed. 

That’s it.  Not even a whiteboard. 

My community college program has a projector and whiteboard but sticking to a tight time schedule with the course calendar is a challenge. 

My CTE classroom has all of the things, including a device for each student (Chromebook etc.), but the challenge here is that the high school students almost need “entertained” while they learn. 

They need loads of activities.

This is “why” the 3 lessons.  Something for everyone.

Meat of the lesson is probably going to be taken from pages in a textbook (I like to use Hartman’s Nursing Assistant Care/Long-Term Care) where students can follow along but you could also make handouts of:

• • Why is fluid intake important

• • Signs and symptoms of dehydration

• • Who is at risk

• • How can nurse aides encourage fluids

• • Why might we have to measure fluid intake

• • What “counts” as fluid intake

• • Conversion practice

• • What is fluid volume (oz. vs. ml)

Let’s Start with Facility Based:

1. Type or draw some basic fluid conversion and tape them on the wall (ie. 1oz=30cc etc) because some facilities don’t even have a projector or even an overhead projector (going way back)

2. Give each student a “whiteboard” using a white sheet of paper inside of a page protector, a dry erase marker and a tissue (for erasing)

3. Practice some basic conversions

4. (Make it real)  gather some commonly used dining containers. I’m sure dietary won’t mind if you borrow some

5. Use a facility “key” of usual measurements. These are sometimes posted in the main kitchen or on the units.

6. Arrange containers varying the fluid (water) inside from full to 75% full, to    50% full, to 25% full, to empty (use food coloring for an easy visual)

7. Have students calculate amount consumed based on what is listed on the “key” as the full amount

8. Documentation and practice

• Visit a resident unit dining area or dining room post meal and assign each student a resident tray

9. Have each student calculate the resident’s fluid intake

10. Have each student document the intake on the I&O record

College/Trade School

1. Give students handout of common conversions (ie. 1oz=30cc, etc) to save time

2. Work through some simple conversion problems.  I like to use my “Fluid Calculation Interactive Game” as a group or the students can access the game on their phones.

I usually project this game onto a screen for the entire class and we work through the problems together.  Click on the picture to check out this resource in my store.

3. Documentation and Practice

   Ideally use a copy of the clinical site’s I&O record OR I have made my own using Google Sheets

4. Set up 3 stations simulating fluids from breakfast, lunch and dinner using common dining containers (coffee cups, water glasses etc).   I would recommend saving other types of common containers (milk cartons, pudding/gelatin/ice cream containers, soda bottles), clean them and use them for this simulation also.

6. Have directions for each meal sitting in front of each tray, letting the students know how much was in each untouched container AND how much each patient/resident consumed. 

This is excellent for our visual learners.

7. Finally, have the students record each meal’s total on the I&O record

Career & Technology Center

1. I still like to use Hartman’s slide presentation that goes with the Nutrition unit but I am careful to only introduce the fluid intake slides as the attention span of a high school student is extremely short, like 10 minutes tops. 

Another suggestion I have is to “link out” to some short videos or visuals to reinforce the topics of: (here are my favorites)

 

• • Why is fluid intake important (https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body)

 

• • Who is at risk (https://health.clevelandclinic.org/drink-up-dehydration-is-an-often-overlooked-health-risk-for-seniors/)

 

• • How can nurse aides encourage fluids (https://www.elder.org/care-guides/24-hours-of-care-at-home/dealing-with-dehydration-elderly/)

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/water-essential-to-your-body

https://health.clevelandclinic.org/drink-up-dehydration-is-an-often-overlooked-health-risk-for-seniors

https://www.elder.org/care-guides/24-hours-of-care-at-home/dealing-with-dehydration-elderly/

 

• •  

…even so, you better have LOTS of activities to go with your lesson!

 

2. Work through some simple conversion problems using a worksheet or my students use a workbook that comes with their textbook (the workbook has some sample problems).  I will usually complete the first 2 or 3 together as a group (step by step), and then give the students a specific time period to complete the rest (ex. 30 minutes), walking around to offer assistance to students needing help.

 

3. Documentation/Lab Practice and Activities

 

• •  If you can, grab an I&O record from your clinical site. If not, as I said before, I like to use my own blank record made in Google Sheets

 

• • Set up 3 stations simulating fluids from breakfast, lunch and dinner using common dining containers (coffee cups, water glasses etc).   I would recommend saving other types of common containers (milk cartons, pudding/gelatin/ice cream containers, soda bottles), clean them and use them for this simulation also.

 

• • Have directions for each meal sitting in front of each tray, letting the students know how much was in each untouched container AND how much each patient/resident consumed.  This is excellent for our visual learners.

 

• • Next, have the students record each meal’s total on the I&O record

Because it can get crowded around these stations, I would recommend having at least two other activities going on at the same time, rotating the groups until all the activities and stations are completed. Here are a few activities I use:

 

Students will calculate fluid intake problems, then match their answer to a color and color the picture correctly. This enables student to visually connect with a concept.

Color by Code

Students will solve the fluid intake calculation problem and find it’s match with the correct answer. This gives students a hands on approach to solving equations.

 

Matching Game

 

In a nutshell, teaching fluid intake measurement to nurse aide students can be a real puzzle, especially when you throw in the mix of different program settings like facilities, colleges, or career & technology centers.

 

It’s a bit of a balancing act for both students and instructors.

 

But hey, recognizing these challenges is the first step, then adapting our teaching methods to fit each unique setting will ensure each Nurse Aide student learns this essential skill.