Children differ from adults both physically and psychologically according to this document. Physically, children have proportionately larger body surfaces, thinner skin, higher respiratory rates, and more rapidly developing tissues and organs. As a result, children are more susceptible to dehydration, absorption of substances through the skin and lungs, and effects on rapidly developing tissues. Psychologically, children experience more separation anxiety and have shorter attention spans than adults. The document outlines many anatomical, physiological and psychological differences between children and adults to highlight how these differences impact nursing care.

1. DIFFERENCE BETWEENADULT AND
CHILD
KIRANDEEP KAUR
ASSISTANT PROFESSOR
CHILD HEALTH NURSING

2. INTRODUCTION
• Children and adults differ physically and
mentally.
• As a nurses it is necessary to learn the
differences to deliver the care accordingly.

3. CLASSIFICATION
CLASSIFICATION:
• Anatomical differences
• Physiological differences
• Psychological differences

4. ANATOMICAL DIFFERENCES::
• SIZE- different sized children according to age.
Thus the usage of various sized cots in
paediatric wards.
• Greater size and WEIGHT of the newborn’s
head as compared to the body length and
weight.
• Immaturity and inadequate ossification- prone
for injuries.
• Sutures and skulls are not united.

5. • Fontanels are not closed.
• Shape of the head and chest can be altered
by constant pressure from lying in one
position.
• Muscles are 25% of weight in infants and it is
40% in adult.

6. DRUG DOSAGE::
• Excessive IV fluids and
medications easily causes pedal
edema.
• Hence rate of flow should be
adjusted.
• Dosage calculation of drug is also
necessary.

7. MOUTH
• Infants tongue is large.
• Nasal and oral airway passages are relatively
small making the baby more prone to airway
obstruction.
• Nose breathers till 6 months of age. (breathing
difficulty in respiratory infections).

8. • EYES:
No tears in early infancy- due to
poor functional development
of lacrimal gland.
• EUSTACHIAN TUBE::
• It is short and straight in
children (10 degree in children
and 40 degree in adults).
• Air sinuses are not fully
developed.
• Sore throat extends to otitis
media because of the
closeness of it to throat.

9. • TRACHEA::
Short and narrow trachea under 5 years-
susceptible to foreign body aspiration.
• GI TRACT::
In children cardiac sphincter of the stomach is
relaxed.
Vomiting is so frequent, hence proper positioning
of the child during feed is so important.
Poor protection of the liver and spleen – prone
for trauma.

10. • EXCRETION::
By utilizing energy substrate for the process of
growth, the load presented to the excretory
pathway is decreased.

11. PHYSIOLOGICAL DIFFERENCES::
ABSOLUTE MEASUREMENTS:
• Rapid loss of 35 ml of blood by a newborn
baby represents 10% of blood volume.
• This much loss can lead to circulatory failure.

12. • BASAL METABOLIC RATE::
 BMR rate is high in newborn.
 In neonate 6-8ml of oxygen/ kg/ min is
normal whereas 2-4 ml of oxygen/kg/min is
normal in adults.
Increased CO2 due to more metabolic rate.
• TEMPERATURE REGULATION::
Poor thermo regulation is attributed to
immaturity of the hypothalamus.
Shivering and sweating mechanisms are
absent in newborn.

13. • Brown adipose tissue in newborn::
Reserve of brown fat from which heat can be
liberated by non shivering thermogenesis .
 Once used brown fat cannot be replaced.
• VOLUNTARY CONTROL::
o No voluntary control over the environment or
activity.
o ( Eg .) On cold day adult used to wear socks,
woolen clothes etc. but the child depends on
the care takers.

14. • PROPORTION OF WATER::
 ICF- Less
ECF- More (double than the adults)
 Easily fluctuates during the GI infections.
• BLOOD VOLUME::
 Neonate- 85 ml/kg of BW
 Adult- 60-70 ml/kg of BW.

15. • GLOMERULAR FILTRATION RATE::
Concentration of urine in newborn is 800
mOsmol /L whereas in adults it is 1400
mOsmol /L.
GFR and tubular functions are lower in
neonates than adult because low blood supply
to kidney, smaller pore size and less filtration
power across nephron .
GFR- 38 ml/ min (neonate)
 GFR- 125 ml/min (adult)

16. • ALIMENTARY TRACT::
o Water absorption is poor – faeces of the child
is watery.
o Dehydration leads to circulatory failure within
24 hours if treatment is inadequate.
• CARDIO VASCULAR SYSTEM::
 Change from fetal to normal circulation.
 Heart rate is more in children.
 Newborn – 110-160 beats/ min.

17. • NORMAL CIRCULATION- FETAL CIRCULATION::
Stoppage of placental circulation
Rt atrial pressure suddenly falls
Decreased pulmonary pressure
Increased left side pressure
Increased left ventricular output
Cessation and reduction of flow via PDA

18. • Functional closure- within few hours after
delivery
• Structural closure- within 6 weeks
 Foramen ovale - fossa ovalis
 Ductus arteriosus - ligamentum arteriosus
Ductus venosus - ligamentum venosum
Umbilical veins- ligamentum teres

19. • RESPIRATION::
• Respiratory rate is 35-40 breaths/ min.
• HEPATIC FUNCTION::
• Immature- physiological jaundice.
• Production of albumin, clotting factors and
vitamin K are less.
• Iron reserve is less.

20. • CENTRAL NERVOUS SYSTEM::
90% of brain growth takes place by 2 years of
age.
Nerve endings in the retina (rods and cones)
are not fully developed. Thus the images are
blurred and colourless for few weeks.

21. PSYCHOLOGICAL DIFFERENCES::
• Fear , escape and avoid strangers till 5 years of
age. Explore the environment.
• INFANCY- more bonding with parents.
Seperation anxiety is very common.
• TODDLERS – Negativistic behaviours.
• PRE SCHOOLER- short attention span, easily
distractable .
• ADOLESCENTS- Identity of peer, confusion.

22. • Children have a proportionately
larger body surface area(BSA) than
adults. The smaller the patient, the
greater the ratio of surface area to
size.

23. • Children have thinner skin than adults.
Their epidermis is thinner and under-
keratinized, compared with adults. As a
result, children are at risk for increased
absorption of agents that can be
absorbed through the skin.

24. • Children have higher respiratory rates
than adults. Higher respirator rates lead
to proportionately higher minute
volumes.
• As a result, children may be more
susceptible to agents absorbed through
the pulmonary route than adults with the
same exposure. Children may also
respond more rapidly to such agents.

25. • Children are generally shorter than
adults, their breathing zone is lower to
the ground. At the same time, many
agents that are aerosolized are heavier
than air.

26. • Children have immature blood-brain
barriers and ENCHANCED central nervous
system (CNS) receptivity.
• As a result, children may exhibit a
prevalence of neurological symptoms.

27. • Children are more prone to dehydration
than adults. At the same time, exposure
to many chemical agents and some
biological agents leads to vomiting and
diarrhea.
• As a result, children may be more
symptomatic and show symptoms earlier
than adults.

28. • Children have a higher proportion of
rapidly growing tissues than adults, and
some agents, including ionizing radiation
and mustard gas, significantly affect
rapidly growing tissues.
• As a result, children are more prone to
ionizing radiation and other agents that
affect rapidly growing tissue than adults.

29. • Children have relatively small airways
compared with adults. The smaller the
caliber of the airway, the greater the
reduction in airflow as a result of
increased pulmonary secretions that
occur following exposure to chemicals or
edema from inhalation of hot gases
• As a result, children suffer more
pulmonary pathology than adults at the
same level of exposure.

30. • While IV medications may be the
recommended prescription, vascular access in
children can be difficult. The smaller the child,
the more difficult vascular access becomes.
Managing the many size-related issues that
arise in acute emergencies presents problems;
the variation in children’s sizes further
complicates the issue.
• As a result, errors and delays in treatment,
and discomfort in drug dosing, may occur.

31. THANX