1. Immature pulmonary - respiratory system rate (increase) eustachian tubes (wider and horizontal) increase amount of lymph tissue, especially in the pharynx area (may obstruct ear tubes) nose breathers tracheal diameter and length (narrower & shorter) alveolar surface - limited (less) thorax shape (rounded) bronchial diameter & length (narrower & shorter) breath sounds - bronchoalveolar vs. vesicular poorly developed thorax muscles (use diaphram) ineffective cough incompetent immune system skin surface is 3- times adult thin skin (increase insensible water loss tongue and epiglottis much larger INFANTS DIFFERENT THAN OLDER CHILDREN/ADULTS

9. Immature cardiovascular: hear rate (increase) ratio between respirations & heart rate is approximately 1:4 (decompensation of cardiac muscle) immature autonomic nervous system arrhythmic heart rhythm blood pressure (low) hydration (easily dehydrated or overhydrated) increase in amount of fluid in extracellular fluid (ECF) increase percentage of body weight is water (full term neonate may be as high as 85% vs. adult which may be 66 %) INFANTS DIFFERENT THAN OLDER CHILDREN/ADULTS

14. To determine hydration of infant: check fontanels weigh infant – same scale- same equipment- sometimes BID weigh diapers 1cc = 1gm

18. Immature GI system: immature cardiac sphincter (regurgitate) smaller stomach capacity stomach lies more left transverse decrease gastric hydrochloric acid small intestine - proportionately greater than adults (secretes more fluid & electrolytes into the intestine) large intestine - proportionately shorter than adults (less opportunity for absorption) Immature pancreas: INFANTS DIFFERENT THAN OLDER CHILDREN/ADULTS Immature liver: decrease bile decrease prothrombin decrease albumin & globulin (remember N- 1 22 & effects with drugs) decrease glycogen stores decrease enzymes (biotransformation of drug)

19. GU: kidney - larger & immature ureters - shorter glomerular filtration; tubular retention & secretion is immature Therefore opportunity for: increase respiratory infection (both upper & lower) increase risk of decompensation of cardiac muscle) poor fluid control (dehydration & overhydration) increase diarrhea increase vomiting acidosis Nursing implications: INFANTS DIFFERENT THAN OLDER CHILDREN/ADULTS