The presentation explains regarding physical, physiological and psychological differences among child and adults

1. Difference between
adult and child

2. CHILDREN ARE NOT LITTLE ADULTS
• Children and adults differ physically and
mentally.
• As a nurses it is necessary to learn the
differences to deliver the care accordingly.

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

4. •
ANATOMICAL DIFFERENCES::
• 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.
• As a result, children are at greater risk of excessive
loss of heat and fluids; children are affected by
more quickly and easily toxins that are absorbed
through the skin.

5. • Immaturity and inadequate ossification- prone for
injuries
• Sutures and skulls are not united.

6. • 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.
DRUG DOSAGE::
• 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. • Thinner skin- 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.

8. MOUTH::
• 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).
EYES::
• EYES: No tears in early
infancy- due to poor
functional development of
lacrimal gland.

9. 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

10. .
TRACHEA::
• TRACHEA: Short and narrow trachea under 5 years-
susceptible to foreign body aspiration.

11. GI TRACT::
• 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.
•
EXCRETION::
• By utilizing energy substrate for the process of
growth, the load presented to the excretory
pathway is decreased.
• Kidney function is reduced.

12. 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.
BASAL METABOLIC RATE::
• 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.

13. TEMPERATURE REGULATION::
• TEMPERATURE REGULATION: Poor thermo regulation
is attributed to immaturity of the hypothalamus.
• Shivering and sweating mechanisms are absent in
newborn.

14. Brown adipose tissue in newborn::
• 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.

15. VOLUNTARY CONTROL::
• VOLUNTARY CONTROL: No voluntary control over
the environment or activity. ( Eg .)
• On cold day adult used to wear socks, woolen
clothes etc. but the child depends on the care
takers.

16. PROPORTION OF WATER::
• PROPORTION OF WATER: ICF- Less ECF- More
(double than the adults) Easily fluctuates during the
GI infections.

17. BLOOD VOLUME::
• BLOOD VOLUME: Neonate- 85 ml/kg of BW. Adult-
60-70 ml/kg of BW.
ALIMENTARY TRACT::
• ALIMENTARY TRACT: Water absorption is poor –
faeces of the child is watery. Dehydration leads to
circulatory failure within 24 hours if treatment is
inadequate.

18. 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)

19. CARDIO VASCULAR SYSTEM::
• Change from fetal to normal circulation.
• Heart rate is more in children.
• Newborn – 110-160 beats/ min.
NORMAL CIRCULATION- FETAL CIRCULATION::
• 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

20. 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.
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

22. • 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.