Kendra Manwill     Infants: Length recumbent Children: Stature Adults: Height, arm span, recumbent height, knee height Pregnancy: Height    Recumbent Length NHANES III For infants less than 24 months old Measure to nearest 0.1 cm  Arm span ◦ Middle fingertip to middle fingertip ◦ Back flat against a wall  Recumbent height ◦ Top of head to bottom of flexed feet  Knee height     Infants: Pan scales Children: Weight Adults: Weight Pregnancy: Weight    Calibrate and tare Measure to nearest ¼ lb Repeat 3 times and average    Minimal clothing, no shoes Distribute weight evenly Record to nearest ¼ lb   Infants: Head circumference Adults: Frame size   Tape should rest just above the eyebrows In the back, tape should be place to measure maximum circumference    Wrist circumference Elbow breadth Krause: page 1214 appendix 21     Infants: Weight-for-length Children: BMI Adults: BMI Pregnancy: BMI     Infant: Plot growth charts Children: Plot growth charts Adults: Waist circumference Pregnancy: Pregnancy growth grid  Premature: ◦ Chronological age: 20 weeks ◦ Premature: 6 weeks ◦ Adjusted age: 14 weeks   9 mo 24 #   Waist Circumference NHANES III High risk: ◦ Men >40 in ◦ Women >35 in  Adults: Waist/hip ratio  Hip Circumference NHANES III   Divide the waist measurement by the hip measurement WHR of 1+ for men or .8+ for women is indicative of android body type  BMI: use prepregnancy weight ◦ Use the correct chart based on BMI  Weight Gain ◦ Based on prepregnancy BMI, use the chart to determine weight gain goals     Station 1: Infant length on recumbent board, infant weight on pan scale, infant head circumference Station 2: Toddler length on recumbent board/stadiometer, toddler weight on pan scale/platform scale, toddler head circumference Station 3: Child height on stadiometer, child weight on platform scale In between or after: Adult measurements and calculations, Pregnancy worksheets LESSON PLAN Title__Anthropometrics_________________________ Target Audience______________________________ Name__Kendra Manwill__________________________ Method________________________________________ Terminal Objective Terminal Concept Learners will be able to replicate anthropometric procedures taught in class Anthropometrics are an important assessment tool to be used in medical nutrition therapy. Domain_Psychomotor______ Taxonomic Level__Mechanism_ References Lab 1 procedures, use and interpretation of growth charts, how to plot weight on prenatal weight gain chart, Krause, Lee RD, Nieman DC, Growth Chart Training Modules Preparation Prepare ppt, recruit infants and children, prepare assignments/ stations for students, delegate responsibility to interns, prepare quiz Pre-assessment Introduction Quiz Read quiz answers Remind students to be careful with children Break them into groups so they can rotate through measuring stations Supporting Objectives Learners will be able to measure height or equivalent for infants, children, adults, and pregnancy Content Outline Infants: length recumbent For children under 24 mo or who cannot stand unaided  Lay child on calibrated length board  One measurer holds infant’s head against headboard, another straightens the body and brings footboard against flexed feet Time Learning Experience (Activity Outline) Slide 2 Slide 3- play video from 3:04-4:27  Measure infant to nearest .1 cm Children: stature For children >2 yrs, or who can stand  Remove shoes and bulky things  Have child stand erect, touch head, back, buttocks, and heels to vertical surface  Align head on Frankfort plane  Lower headpiece to touch crown of head, measure to nearest 1 mm Slide 4 Adults, pregnancy: height  Same method as for children  Measure to nearest .1 cm Adults: arm span  Stand w/ back against a wall, arms outstretched  Measure middle fingertip to middle fingertip Adults: recumbent height  Make bed/surface level  Straighten body, flex feet  Extend perpendicular lines from top of head and bottom of the feet out to one side of bed  Measure distance to nearest .5 cm Adults: knee height  Bend left knee and ankle 90 degree  Place fixed caliper blade under Slide 5   Learners will be able to measure weight for infants, children, adults, and pregnancy heel. Press sliding blade down against the thigh about 2” behind kneecap To hold the measurement, push the locking lever away from the blades. Measure to nearest .1 cm Repeat once more, make sure they are within .5cm Infants: pan scales  Tare to account for anything on the child  Measure weight to nearest .25#  Repeat weight 3x and average Children, adults, pregnancy: weight  Use a platform scale  Weight at the same time each day  Adjust beam from behind, don’t reach around subject  Remove shoes and bulky clothes  Measure to nearest .25# Learners will be able to measure frame size or equivalent for infants and adults Slide 6 Slide 7 Slide 8 Infants: head circumference  Face left side of head  Place nonstretch tape about ¼” wide around head  Tape should be just above eyebrows and measure max circumference  Record to nearest cm or mm Slide 9 Slide 10- Demo on an intern Adults: frame size Slide 11 Wrist circumference  Flex right arm at elbow, palm up  Measure wrist around smallest part. It should fit into depression in front of wrist bond and touch all skin  Record to nearest .1 cm  Use equation in Krause to calculate frame size from circumference (page 1214) Elbow breadth  Right arm extended, forearm bend upwards at 90 degree angle.  Place caliper between two prominent bones on either side of elbow.  Measure to nearest 1/8 “  Compare measurement to Krause Learners will be able to measure BMI or equivalent for infants, children, adults, and pregnancy Infants: weight-for-length  Will demonstrate charts under “growth”  Use weight and length as described previously Children, adults, pregnancy: BMI  Use correct procedures to obtain height and weight  Calculate BMI using kg/m2  Interpret BMI using NHLBI BMI standards- Krause appx 23 Demo on intern Demo on intern Slide 12 Learners will be able to Infant and children: plot growth charts measure growth or equivalent  Determine infant’s age, correct for infants, children, adults, and for gestational age if necessary pregnancy  Plot length-for-age, weight-forage, head circumference-for-age, and weight-for-age Adults: waist circumference  Place measuring tape in a horizontal plane around the abdomen at the level of the iliac crest  Measure at the end of a normal expiration  High risk waist circumference: men >40, women >35” Slide 13 Slide 14- explain how to calculate age Slide 15- have someone point to the spot and say what percentile the child is at Slide 16- show video from 1:00-2:08 Pregnancy: pregnancy growth grid  Using “gestational wheel” and based on due date, determine which week of pregnancy each weight was obtained at  Plot the client’s growth on correct pregnancy growth grid  First plot is zero (prepregnancy weight) Learners will be able to measure waist/hip ratio of adults Waist/hip ratio  Waist: smallest area between rib cage and hips  Hips: largest circumference between waist and knees  Divide waist measurement by hip measurement to determine WHR. WHR or 1 or greater for men and Slide 17- show video from 2:13-3:14 .8 or greater for women is indicative of android body type and an increased risk for obesityrelated diseases Learners will be able to use Pregnancy Charts to determine weight gain goals for pregnancy women Use appropriate chart (determined by BMI) to determine weight gain goals per week of pregnancy Slide 18 Slide 19- explain axis Assessment (evaluation) Students will fill out the worksheets as they progress through the lab Closure Station 1: Infant length on recumbent board, infant weight on pan scale, infant head circumference Station 2: Toddler length on recumbent board/stadiometer, toddler weight on pan scale/platform scale, toddler head circumference Station 3: Child height on stadiometer, child weight on platform scale In between or after: Adult measurements and calculations, Pregnancy worksheets