Nutrition Assessment Techniques

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Questions and Answers

What is the recommended position for a subject being measured with a stadiometer?

Sitting with legs crossed and head tilted

Heels together and head in the Frankfort horizontal plane (correct)

Feet apart and arms raised

Standing on one leg with arms at shoulder height

What should be done if a subject cannot touch all four points against the stadiometer?

Measure while they are seated instead

Instruct them to push harder until they can

Have them touch at least two or three points or estimate height from knee height (correct)

Ignore the height measurement completely

How should the measurement be taken with regard to head positioning?

The head should be tilted backwards

The head should be cradled to ensure accuracy

The head should be at level with the eyes while measuring (correct)

The subject should maintain a slouched posture

What is the purpose of measuring head circumference in infants?

To detect abnormalities in head and brain growth Signup and view all the answers

At what age is it recommended to routinely measure head circumference?

From birth until age 36 months Signup and view all the answers

What is the recommended tool for measuring head circumference accurately?

A flexible, non-stretchable measuring tape Signup and view all the answers

Which condition might lead to inaccurate height measurements in nonambulatory persons?

Severe spinal curvature Signup and view all the answers

Before taking a height measurement, what should the subject do?

Take a deep breath and hold it Signup and view all the answers

What is the optimal position for the lower edge of the tape when measuring head circumference?

Above the eyebrows Signup and view all the answers

Which type of scale is recommended for measuring body weight in nutritional assessments?

Electronic scale Signup and view all the answers

Why are electronic scales considered advantageous for weighing infants?

They provide real-time weight data Signup and view all the answers

What should be checked after moving a balance beam scale?

The zero weight on the scale Signup and view all the answers

How often should the accuracy of scales be assured using standard weights or by a professional dealer?

Two or three times a year Signup and view all the answers

What is a disadvantage of spring-type bathroom scales according to the guidelines?

They become inaccurate after repeated use Signup and view all the answers

How should the tape be positioned during the measurement of head circumference?

Snug to compress the hair Signup and view all the answers

What feature of electronic scales helps reduce the error in reading measurements?

Large digital output Signup and view all the answers

What is the primary purpose of clothing consideration when weighing a subject?

To provide a more accurate weight measurement. Signup and view all the answers

What is one method used to weigh nonambulatory persons?

Bed scale. Signup and view all the answers

What is a key requirement for reading weight on a chair scale?

The subject must be still. Signup and view all the answers

What advantage does SKINFOld measurement have compared to hydrostatic weighing?

It provides a faster result. Signup and view all the answers

From which side do most North American investigators typically take skinfold measurements?

Right side. Signup and view all the answers

What should inexperienced practitioners do before measuring skinfolds?

Mark the site after identifying it. Signup and view all the answers

What is a common error made when estimating percent body fat with skinfold measurements?

Ignoring the subject's clothing weight. Signup and view all the answers

How closely should the second reading of weight agree with the first for reliability?

Within 100 g or ¼ lb. Signup and view all the answers

What is the primary purpose of the measuring scale in relation to the child?

To read the child's length from the footboard. Signup and view all the answers

What should be done with the child's head during the length measurement?

Hold it against the headboard. Signup and view all the answers

Which measurement technique is NOT recommended for stature?

Using a moveable rod on a platform scale. Signup and view all the answers

What is essential for measuring a child’s recumbent length accurately?

Having two persons for the measurement. Signup and view all the answers

How should length be recorded during measurement?

To the nearest 0.1 cm or in. Signup and view all the answers

What is the Frankfort plane's position during measuring?

Perpendicular to the backboard. Signup and view all the answers

What should be done if a child cannot be properly positioned during the measurement?

Estimate the length and note the circumstances. Signup and view all the answers

Why should shoes or socks be removed during measurement?

To ensure accurate measurement of length. Signup and view all the answers

What is the recommended type of scale for weighing infants?

Pan-type pediatric electronic scale Signup and view all the answers

Why should scales with wheels not be used?

They require recalibration every time they are moved. Signup and view all the answers

What should be done to ensure an accurate measurement when weighing an infant with a diaper?

Weigh the infant and subtract the weight of the diaper. Signup and view all the answers

When should weights of children and adults ideally be taken?

After voiding and wearing light clothing. Signup and view all the answers

What is the significance of the average of two or three weight measurements for infants?

It minimizes the effects of excessive movement. Signup and view all the answers

What is the accuracy requirement for weighing children and adults on a scale?

Accuracy to within 100 g (0.1 kg) or 0.5 lb Signup and view all the answers

How should the weight of clothing be handled when measuring a child's weight?

Whether to subtract it depends on the purpose of the measurement. Signup and view all the answers

What is the recommended practice if the infant is too active to be weighed on a baby scale?

Weigh the infant on a platform scale while being held and derive the weight by difference. Signup and view all the answers

What is the main purpose of using a flexible nonstretchable tape measure in skinfold measurement?

To locate midpoints on the body Signup and view all the answers

What should be the position of the caliper when measuring a skinfold?

Perpendicular to the long axis of the skinfold Signup and view all the answers

Why should measurements be taken at least 15 seconds apart?

To allow skinfold site to return to normal Signup and view all the answers

What happens if caliper tips exert force for more than 4 seconds?

The reading gradually becomes smaller Signup and view all the answers

What is crucial for achieving consistent skinfold measurements?

Training several technicians to compare results Signup and view all the answers

Why should measurements not be taken immediately after exercise?

Body fluids shift to the skin affecting normal skinfold size Signup and view all the answers

What is the recommended practice regarding the placement of caliper tips?

They should be placed about 1 cm distal to the fingers holding the skinfold Signup and view all the answers

Which type of caliper is considered most popular in the U.S. for skinfold measurements?

Lange Skinfold Caliper Signup and view all the answers

Study Notes

Anthropometry

Anthropometry is the measurement of body size, weight, and proportions
Anthropometric measures are indicators of health, development, and growth in infants and children
Anthropometry can evaluate nutritional status, such as obesity or emaciation from malnutrition
Useful for monitoring effects of nutritional interventions, disease, trauma, or surgery
Considered the method of choice for estimating body composition in clinical settings

Measuring Length, Stature, and Head Circumference

Measurements of length, stature, and head circumference are fundamental and easily obtained anthropometric measurements
These measurements are particularly sensitive indicators of health in infants and children

Assessing Growth and Development

A child's growth and development can be assessed by comparing stature for age, weight for age, weight for stature, and BMI for age with standards from studies of large groups of healthy children

Calculating Indices and Estimating Expenditure

Stature is crucial for calculating indices such as weight for stature, weight divided by stature, and the creatinine height index, used in estimating basal energy expenditure

Frankfort Horizontal Plane

In stature measurements, positioning the head in the Frankfort horizontal plane is critical
The Frankfort horizontal plane is a line between the lowest point on the margin of the eye socket (orbit) and the tragion (notch above the tragus, a cartilaginous projection in front of the ear lobe)
With the head in line with the spine, this plane should be horizontal

Measuring Length

Length (recumbent length) is used for children younger than 24 months or those who cannot stand without assistance
Recumbent length is measured when the subject is lying down

Growth Charts

Growth charts for ages birth to 36 months are based on recumbent length
Growth charts for ages 2 to 20 years are based on stature

Recumbent Length Measurement Technique

Measuring recumbent length requires a device with a stationary headboard and moveable footboard, perpendicular to the backboard
The measuring scale should have zero at the edge of the headboard
Two people are needed; one holds the child's head, insuring the Frankfort horizontal plane, and the other measures the length

Stature Measurement Technique

Stature, or standing height, can be measured in subjects aged 2 to 3 years and older who can stand without assistance
One method involves attaching a measuring stick or tape measure to a vertical surface (like a wall) and using a right-angled headboard to read the measurement

Stature Measurement Techniques (Continued)

A wall should not have a thick baseboard and the subject should not stand on a carpet as this can affect the accuracy
The use of a moveable rod on a platform scale is not recommended due to lack of rigidity and inconsistent headboard alignment
A stadiometer, like the Harpeden or Seca, is a preferred method
Barefoot and minimal clothing are required to facilitate correct positioning of the body. The subject should stand with heels together, arms to the side, and legs straight. Shoulders relaxed. Head should be in the Frankfort horizontal plane

Stature Measurement Techniques (Additional Considerations)

Obese individuals with protruding buttocks or curvature of the spine may not be able to touch needed points on the stadiometer
In these cases, two or three points may need to be used or height estimated from knee height
Subjects should inhale deeply and hold their breath when measuring
Measurements should be read to 0.1 cm or in. with eye level to the headboard to avoid parallax

Head Circumference Measurement

Head circumference measurement is used to detect abnormalities in head and brain growth
Crucial in the first year of life, although conditions may not be related to nutrition
Head circumference increases rapidly in the first 12 months, then growth is much slower
Measurement is recommended routinely in infants and young children up to 36 months

Head Circumference Measurement Technique

Head circumference is easiest to measure when infant or child is sitting on caregiver's lap
Older children may be measured while standing
A flexible, non-stretchable measuring tape is required
The tape should be in the same plane on both sides of the head, pulled snug to compress the hair
The measurement should be read to the nearest 0.1 cm or in., written in the infant's file, reliability of the measurement verified by a second reading

Measuring Weight

Body weight is a critical nutritional assessment measurement
Helpful in equations predicting caloric expenditure and indices of body composition
Weight should be taken with an electronic or balance-beam scale
Electronic scales are often lighter, more portable, and faster, as well as easily reading digital output in metric or English units

Weight Measurement Technique (Infants)

Infants should be weighed using a pan-type pediatric electronic or balance-beam scale accurate to 10g (0.01 kg) or .5 oz
Cushions or diapers used are weighed and measurements then subtracted from the infant's weight

Weight Measurement Technique (Children and Adults)

Children and adults who can stand without assistance should be weighed using a platform electronic or balance beam scale, accurate to 100g (.1kg) or 25 lb
The weight should be read down to the nearest .1 kg or .25 lb
Two immediate measurements need to be within 100g or .25 lb - for infants - measurements need to taken nude, or with weight of diaper subtracted

Weight Measurement Technique Considerations

Scales should be placed on a hard flat surface; re-calibration is necessary after movement of the scale; Spring-type bathroom scales are not recommended due to possible loss of accuracy
Ideally child or adult should be measured after voiding and dressed in an examination gown of known weight or light underclothing

Non-Ambulatory Person Weight Measurement

Non-ambulatory people can be weighed on bed scales or chair scales
Position comfortably in the weighing sling or sit upright in the chair, with body weight equally distributed on both feet
Measurements should be taken using either method, the weight should be recorded to 0.1 kg or .25 lb

Skinfold Measurements

Skinfold measurements are the most widely used method to measure and indirectly estimate percent body fat in clinical settings using the thickness of a skin fold
Equipment is inexpensive and useful for obtaining measurements in a small space; measurements are taken quickly
Skinfold measurements correlate well with those determined by hydrostatic weighing

Skinfold Measurement Technique

Proper measurement of skin folds requires care in site selection and adherence to standard protocols
Most North American researchers measure skin folds on the right side of the body. European researchers most commonly measure on the left.
The skin fold should be correctly grasped by thumb and index finger from the correct proximal site
The caliper should be held perpendicular to the long axis and with the dial facing up
The caliper should not be placed too deeply into or too close to the tip of the skin fold
The reading should be taken approximately 4 seconds after pressure is released from the caliper arm
Two measurements should be taken at least 15 seconds apart, to allow the skin fold to return to its normal state
Measurements, should not be taken immediately after exercising or when the subject is overheating. It takes practice

Skinfold Measurement Technique Continued

Several types of skin fold calipers are available; the Lange skin fold caliper is among the most popular; less expensive, plastic calipers are available (eg, Slim Guide, Fat-control)
Consistent techniques should be tested by having different technicians take measurements

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Description

This quiz covers essential techniques and practices in measuring height, head circumference, and body weight for nutritional assessments. It addresses best practices for using stadiometers and scales, ensuring accurate measurements, and the importance of head circumference in infants. Gain insight into the proper protocols for accurately assessing nutritional status.