Med-Surg HESI Study Guide|Med-Surg HESI Study Guide
Med-Surg HESI Study Guide
-Health Promotion For Infancy-Elderly
-Normal Aging's Effects on Body
... [Show More] Systems
-Integumentary System
Loss of Pigment in Hair/Skin
Wrinkling of Skin
Thinning of Epidermis, Easy Bruising & Tearing of Skin
Decreased Skin Turgor, Elasticity, & Subcutaneous Fat
Increased Nail Thickness & Decreased Nail Growth
Decreased Perspiration
Dry, itchy, scaly skin
Seborrhic dematitis & keratosis formation (overgrowth & thickening of skin)
-Neurological System
Slowed reflexes
Slight tremors & difficulty with fine motor movement
Loss of balance
Increased incidence of awakening after sleep onset
Increased susceptibility to hypothermia & hyperthermia
Short-term memory decline possible
Long-term memory usually maintained
-Musculoskeletal System
Decreased muscle mass & strength
Decreased mobility, range of motion, flexibility, coordination, & stability
Change of gait, with shortened step and wider base
Posture and stature changes causing a decrease in height
Increased brittleness of the bones
Deterioration of joint capsule components
Kyphosis of the dorsal spine (increased convexity in the curvature)
-Cardiovascular System
Diminished energy and endurance, with lowered tolerance to exercise
Decreased compliance of the heart muscle, with valves becoming thicker & more rigid
Decreased cardiac output and decreased efficiency of blood return to the heart
Decreased compensatory response, so less able to respond to increased demands on the
cardiovascular system
Decreased resting heart rate
Weak periphreal pulses
Increased blood pressure but susceptibility to postural hypotension
-Respiratory System
Decreased stretch and compliance of the chest wall
Decreased strength and function of respiratory muscles
Decreased size & number of alveoli
Decreased depth of respirations and oxygen intake but not respiratory rate
Decreased ability to cough and expectorate sputum
-Hematological System
Hemoglobin and Hematocrit average levels toward low end of normal
Prone to increased blood clotting
Decreased protein available for protein-bound medications
-Immune System
Tendency for lymphocyte counts to be low with altered immunoglobulin production
Decreased resistance to infection and disease
-GI System
Decreased need for calories due to lowered basal metabolic rate
Decreased appetite, thirst, and oral intake
Decreased lean body weight
Decreased stomach emptying time
Increased tendency toward constipation
Increased susceptibility for dehydration
Tooth loss
Difficulty in swallowing food
-Endocrine System
Decreased secretion of hormones, with specific changes related to each hormone's
function
Decreased metabolic rate
Decreased glucose tolerance, with resistance to insulin in periphreal tissues
-Renal System
Decreased kidney size, function, & ability to concentrate urine
Decreased glomerular filtration rate
Decreased capacity of the bladder
Increased residual urine and increased incidence of infection and possibly incontinence
Imparied medication excretion
-Reproductive System
Decreased testosterone production and decreased size of testes
Changes in prostate gland, leading to urinary problems
Decreased secretion of hormones with the cessation of menses
Vaginal changes, including decreased muscle tone & lubrication
Impotence or sexual dysfunction for both genders depending on health, medications
-Normal Vitals For Infancy-Elderly
Age Resting HR Respirations Temperature Blood Pressure
Newborn 100-160 bpm 30-60 breaths/min 96.8-99 Axillary Avg. 73/55
Infant 90-130 bpm 20-40 breaths/min 97-99 Axillary Avg. 90/56
Toddler 80-120 bpm 20-30 breaths/min 97.5-98.6 Axillary Avg. 92/55
Preschooler 70-110 bpm 16-22 breaths/min 97.5-98.6 Axillary Avg. 95/57
School-Age 60-100 bpm 18-20 breaths/min 97.5-98.6 Oral Avg. 107/64
Adolescent 55-90 bpm 12-20 breaths/min 97.5-98.6 Oral Avg. 121/70
Adult 60-100 bpm 12-20 breaths/min 97.5-98.6 Oral Avg. 120/80
-Nutritional Assessment of Elderly
Food intake can be decreased from loss of appetite, swallowing or chewing difficulties, or GI problems
Mobility issues can affect ability to shop for and prepare healthy food
Neuropsychological problems can affect ability to prepare own food and eat proper diet
Ensure proper fluid/fiber intake to prevent constipation & dehydration
Financial hardships can also affect the ability to afford health foods
Psychological stress can cause problems with lack of eating/anorexia
Patient BMI can have a bearing on what kind of diet they need
-Care of The Hospitalized Child
Neonate
-Anticipate needs and fulfill them in a timely manner
-Provide opportunities for comfort sucking and oral stimulation with a pacifier
-Provide swaddling, with the infant's hands drawn to midline and close to face; use soft voice
-Provide a quiet soothing environment if very ill
-Provide stimulation for each sense when appropriate
-Watch for overstimulation; eye avoidance, extension of arms, splaying of fingers, zoning-out
-Before painful procedures, provide comfort touching and sucking,
-Follow painful procedures with tucking, holding, and cuddling
-Model and share appropriate behaviors with family members regarding stimulation, touch, feeding
-Provide consistent caregivers when parents are not available
-Collaborate with parents on ways to provide care
-Involve the parents in care as much as possible
-Encourage parents to room-in if possible
Infant
-For younger infant, provide same care as neonate
-Older infant will being to anticipate painful procedures and fight; swaddle with blankets
-Expect regression and inform parents to expect it and why
-Limit the number of caregivers to whom the infant must adjust
-Request that parents bring the infant's security object
-Encourage parents to be present during procedures
Toddler
-Expect regression and inform parents about behaviors
-Follow home routines and rituals
-Involve parents in the care of the toddler
-Provide for rooming-in if possible
-Allow opportunities for mobility when.... [Show Less]