sp follow ( cEDURE-3: ANTHROPOMETRy op PReESSMENT OF GROWTH PARAMETERS OF CHILDREN -jinical Guidelines c pometry is the science of measuring the } Anthro nt "ody. Usually body weight, length or height and circumference are measured to assess the phy growth of the children and to detect any abno deviations as failure to thrive or growth retardation. Chest circumference and MUAC measurements also help in detection of abnormal growth and nutritional status of the children « Growth parameters assessments are obtained at eack visit to the healthcare facilities or at each home visit by the healthcare provider to detect growth failure. I: is essential for all children on admission to healthcare institutions, as baseline data for planning of treatment Daily weight recording at same time, ideally in the Morning before breakfast, using same weighing machineof hospi hospitalized children is essential and important for . Heulation OF TV fluid therapy and dose of medication Should be measured in all hospitalized children, specially for children with abnormal cardiac and renal functions with evidence of accumulation of fluid as edema, fluid and electrolyte imbalances, excessive loss of body fluids in diseases conditions and to assess nutritional status * Recumbent tength is measured usually up to 2 years of age of the child in lying down position ne sing infantometer PR PIe tape measure, After 2 years of age, standing docs measured using stadiometer, a measuring oe to a wall or height assessment rod oo weighing scale or electronic length/height ‘asurement device or wall tape measure (prepared by using ordinary tape measure on a wall). ~ Length or height is an important growth parameter, Measurement of this parameter is essential to detect stunting (low height for age) and wasting (low weight for height). Itis also required to calculate BMI, which indicates and helps to estimate obesity, overweight or underweight. BMI is calculated by dividing body weight in kilograms by height in meter squared. Head circumference is related to brain growth and development of intracranial volume in children Head circumference measurement helps to detect abnormal increase in size and shape of the child (¢.g., hydrocephalus, microcephaly, oxycephaly, etc.). It is measured as occipitofrontal circumference (OFC) over the most prominent points of head + Chest circumference and MUAC measurements help to assess growth and nutritional status of the children. Abnormal shape of chest in children is found in malnutrition, rickets and congenital heart diseases. Measurement of MUAC is required to identify severe acute malnutrition (SAM) among children, which is a significant contributing factor of childhood illnesses and deaths. + Assessment of growth parameter can be done on child’s, bed or in the procedure room in presence of the parent for safety and privacy of the child and to gain their cooperation. a 3 Equipment Required + Hand hygiene supplies for hand washing and hand rubbing to prevent cross infections + Weighing scale (as appropriate): Lying-in weighing scale for younger child (infant/toddler) or stand-up scale for older child or bed scale for bed ridden child * Measuring tape or infantometer for assessment of recumbent length for younger child and Stadiometer or measuring tape for assessment of standing height of the older child = Drapes or sheet or paper to place on weighing scale pan/ tray and on infantometer + Disinfectant solution for cleaning the weighing scale tray/panHealth Nursing Procedures for Medical Condi Performing the Ste Point of Emphasis Measuring Body Weight + Note the previous body weight of the child, if available, . Perform hand hygiene and assem! - Ensure the weighin; . Ensure the room is warm and no fan i . Place a light drape/sheet or container Abottle of 70% alcohol and cotton swabs in a conti sure, fused to clean the tape measure, vamormal Standard Growth Chart to identify normal or abnormality of growth parameters Calculator 0 ssBM ofthe child Waste disposal containers as per BMW rule Documentation sheet or child’s case she Assessment and Preparation + Assess child's previous growth pattern and most recent ings of weight, length/height, head circumfer eae, chest circumference, and MUAC. Assess child’s and family members understanding level about the importance of assessment of growth parameters Self preparation: Follow standard precautions of infection control and gentle approach Environment should be warm, clean, well ventilated and well lighted Articles preparation: All necessary articles and equipment should be arranged near the child at bedside or at procedure room, as convenient. Cleanliness must be maintained Preparation of parents: Explain the procedure of anthropometry and its importance to the parents, Encourage them to participate during the measurement to reduce stress of the child and to get cooperation, Answer to their questions in simple words, Preparation of child: Explain the procedure of anthro- Pometry in age appropriate language. Make the child clean and comfortable. Answer to his or her concern re- lated to the ‘measurement procedure, whenever needed. ps of Procedure with Rationale/ Tt serves as baseline data to detect any weight changes, ble all required items near the child, Use digital weighing scale with a pan/tray to place the child during weight measurement for the children aged below 24 months of age. 8 scale is cleaned/disinfected and placed on firm flat surface. is running. Weight can be measured at bed side or in the treatment room, or procedure room, Paper on the scale pan and calibrate the scale to “0” position, - Completely undress the infant/toddler and safely place on the pan at the middle of the weighing scale. Children aged below 24 months should be weighed nude without any cloths for accurate body weight determination, Remove the dress and diaper of the child. One small sheet can be used to cover the child on the tray/pan of the scale, if complete undressing is not allowed. Child can have diaper in place. Remey, the weight of sheet and diaper fom ye ti recorded. Oa 8. Keep your one hand slightly above weighing scale to prevent accides i. Ifthe childs extr ful or ac meastirement may be done by h hold the child in his or her arn¢ weighing machine, Weigh p; first and then weigh the p chile’s weight, subtract wi the chiig ntal fal whi ctive, Bt of parent alo, “ the weight of parent and child togethes A" 9. Use stand-up weighing scale for ambulaog older than 24 months of age. Determine ad child isable tos Ensure the scale or drape on th i. Ask the child to remove shoes and he. Light clothing is allowed unless other. acy must be maintained. Do not ma child nude ii, Assist the child to stand on the weighing with arms hanging at his or her sides of bo . Ask the child to be still on the weighing Ensure the scale is not shaking. 10. Note the child's weight in gram for young inf kilograms for older child. Weight in kilogramsis calculation of medication doses and IV fluid th Carefully remove the infant/toddler from the scale. Redress the child and put on diaper. Retr child to parent's arm or crib securely. Assist the ol child to step down from stand-up weighing se needed. Dispose the drape or paper from the weighin Disinfect the weighing scale (as per insti Policy) each time after use to prevent transmission microorganisms, Dispose all waste. Rearrange reusable articles"! equipment for next use. Ensure the child is comfortable. Perform hand hy Document the child's weight on child’s hospital and on growth chart, and and balance on the isin “0” position. Plac le ap ll 12, 13, 14, 15, Measuring Recumbent Length and Standing Height 1. Note the child’s age and previous length ot hi of measurement value, if available. It helps t0 4 changes in child’s length or height 2. Perform hand hygiene. Make the child comfort! measurement of length or height. 3. Ensure infantometer or measuring tape na assessing recumbent length of the young ch years of age. 4, Place Tight drape or paper on flat surface Measuring board or on infantometer to provid and to protect from cross contamination. ; 5. For use ofinfantometer, ay the nfant/toddle n, placing the vertex of the child's it eft etoan dupe on ia ot jerinsi ail! 4