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 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

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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


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

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