CNA Procedure: Measuring Height and Weight & I&O

2.5 centimeters or cm equal

1 inch

2.2 lb or pounds equal

1 kilogram

Types of scales

Chair, wheelchair, Bed, Sling, Baby & Standard Dr. scale

Weight and Height Measurements

Changes in weight are often used as an indicator of the patient's condition. - A baseline (original) measurement of height and weight is usually obtained when the patient is admitted. These measurements are usually noted on the Kardex. - Weights are frequently measured when patients are given drugs (diuretics) to increase their urine output. - Weight is an indicator of the patient's nutritional status. - Measurements of weight and height must be accurate and recorded according to facility policy, because medications may be ordered according to the patient's size. - Height measurements may be recorded in feet (') and inches (") or in centimeters (cm). - Weight measurements may be recorded in pounds (lb) or kilograms (kg). Note: Some facilities use the metric system, so you may be recording weight in kilograms. If your facility uses this measurement system, the scales will be calibrated for the metric system. You will not be required to convert measurements from the inch and pound system to the metric system. - The upright scale is used for ambulatory patients who can stand unattended on the platform. - A mechanical lift with scale can be used to weigh patients who cannot stand when a wheelchair scale is not available. - Sling scales can be used to weigh patients whose conditions do not permit the use of a mechanical lift/scale. - Chair scales are used to weigh patients who cannot stand long enough to be weighed, and are seated in chairs or wheelchairs.

signs of dehydration

Dry mouth, fatigue, dizziness, weakness, flushed skin, headache, blurred vision, sunken fontanels in a baby, & even death, if not corrected quickly

overhydration

Excess water in the extracellular spaces

Height bar attached to balance beam scale

Height is measured with the ruler attached to an upright scale or with a tape measure when the patient is in bed;read the ruler @ the break of the bar in inches & centimeters.

ways to ^ hydration for pt. in a hospital

IV, Subclavian IV, Push fluids, force fluids, feeding tube, etc.

CNA Procedure: Measuring Wt. & Ht. of a Patient in Bed

Measuring the Patient in Bed 1-14. Carry out initial procedure actions. 15. Assemble equipment: - Tape measure - Pad and pen 16. a. Position the patient in the supine position. b. Straighten the patient's back, arms, and legs so that she is lying as straight as possible. c. Straighten and tighten the sheets. d. Place a pencil mark on the sheet even with the patient's head. e. Place another pencil mark at the level of the patient's heels. f. Measure the distance between the two marks with a tape measure to obtain the patient's height. g. Carry out ending procedure actions.

ways to prevent overhydration

RN & LPN must control IV carefully, place IVAC or pump drip controller & attach to IV on the pt. when IV in use, monitor intake & only allow limited amounts of drink on diet tray & @ bedside.

obesity

Refers specifically to adults who have a BMI of 30 or higher; an excessive accumulation of fat in the body

Lines on the bar found on balance beam scale/drs. scale for pt. weight

The lower bar indicates weights in 50-pound increments (amounts). - The upper bar denotes one-quarter-pound increments. - The even-numbered pounds are marked with numbers. - The long line between each number indicates the odd-numbered pounds. - Each small line indicates one-quarter pound, or 4 ounces.

explanation of how to add the two bars together for weight

The two figures are added and recorded as the person's total weight. The sum is recorded according to facility policy in either pounds or kilograms. For example: Lower bar = 100 pounds Upper bar= 22 pounds Total Wt or pt. = 122 pounds

Guidelines for Obtaining Accurate Weight & Height Measurements

To obtain an accurate weight measurement, you must: - Always balance the scale before using it so the weights hang free. - Have the patient empty his or her bladder. - If the patient uses incontinent briefs, be sure the brief is dry before weighing. - If the patient has an indwelling catheter, empty the bag before weighing. - Weigh the patient at the same time of day each time. - Have the patient wear the same type of garments each time. - Use the same method and the same scale each time, if possible. - If the patient has a cast, has recently had a cast removed, or has new onset edema, consult the nurse about possible weight discrepancies. You must learn to read the scale correctly. There are two bars on the upright scale. The balance bar should hang free to start.

CNA Procedure: Measuring Wt. & Ht. Using a Bed Scale

Using a Bed Scale 1- 10. Carry out initial procedure actions. 11. Assemble equipment: - Manual or electronic bed scale or mechanical lift scale - Chains and straps - Clean sheet 12. Follow the guidelines in Procedure 20 for assisting the patient into the lift seat or sling. 13. a. Balance the scale with the canvas seat, clean sheet, chains, or straps attached. The bars should hang freely. b. Cover the sling with a clean sheet if the patient is undressed. c. Remove the sling from the scale and position the patient on the sling. d. Connect the straps and elevate the lift above the level of the bed. Raise the sling so the patient's body and the sling hang freely over the bed. e. Adjust the weights until the balance bar hangs freely on the end, or read the electronic display screen. Remember this number or write it on your note pad. f. Lower the patient back into the bed and remove the sling. g. Carry out ending procedure actions.

CNA Procedure: Measuring Weight and Height Using a Chair Scale

Using a Chair Scale Note: This procedure refers to a scale with a permanently mounted chair. 1-4. Carry out initial procedure actions. 5. Assemble equipment: - Chair scale - Wheelchair - Transfer belt 6. a. Balance the scale so the weights hang free. b. Apply a transfer belt to the patient and assist in a pivot transfer to the wheelchair. c. Take the patient in the wheelchair to the chair scale. Lock the brakes. Be sure the brakes of the chair scale are locked in place. d. Apply a transfer belt to the patient and assist in a pivot transfer to the chair on the scale. Instruct the patient to sit down when the chair is felt against the back of the legs. Once the patient is seated, be sure the patient's feet are on the footrest(s) of the chair. e. Walk behind the scale to obtain the reading. f. Transfer the patient back to the wheelchair. g. Carry out ending procedure actions.

CNA Procedure: Measuring Weight and Height Using a Standard Scale

Using a Standing Scale 1. Carry out initial procedure actions. 2. Assemble equipment: - Scale, Paper towels, Pad and pen 3. a. Balance the scale so the bar hangs freely on the end. b. Place a paper towel on the scale platform. c. Assist the patient to remove shoes and stand on the platform. d. Move the weights on top bar first, until they hang freely. e. Move wt. on second bar & add the amounts on the two bars to determine the patient's weight. Write this down on your note pad or remember it. f. Assist the patient to turn around, facing away from the scale. g. Raise the height bar until it is level with the top of the patient's head. h. Record the measurement in the center of the height bar. i. Help the patient down from the scale and assist to put on shoes, if necessary. j. Remove and discard the paper towel. k. Carry out ending procedure actions.

CNA Procedure : Measuring Wt.& Ht. Using a Wheelchair Scale

Using a Wheelchair Scale 1-7. Carry out initial procedure actions. 8. Assemble equipment: - Wheelchair scale - Wheelchair - Transfer belt 9. a. Balance the scale so the weights hang free. b. Obtain a wheelchair. Take it to the scale and weigh it. c. Write down the weight. d. Take the wheelchair to the patient's room. Apply a transfer belt to the patient and assist in a pivot transfer to the wheelchair. e. Take the patient to the scale. Roll the wheelchair up the ramp and lock the brakes. f. Adjust the weights until the balance bar hangs freely on the end. Write down this number on your note pad. g. Unlock the brakes and slowly guide the wheelchair down the ramp. h. Return to the patient's room and assist the patient to transfer out of the wheelchair. i. Subtract the weight of the empty wheelchair from the total weight of the patient and chair and record this number. j. Carry out ending procedure actions.

Can measuring wt. accurately be serious or could it lead to a life/death situation?

Yes, so make sure to follow Drs. order if daily wt. is ordered by physician.

When weighing a patient on the balance scale, you know that each long marking on the lower bar represents

a. 1 pound. b. 5 pounds. c. 25 pounds. d. 50 pounds.

When measuring a patient's height using the ruler bar on the balance scale, you will read the height measurement

a. at the top of the height bar. b. on the lower balance beam. c. at the movable part of the height bar. d. in the center of the ruler.

You are assigned to weigh Mrs. Abrera using an electronic scale. When you plug the unit into the outlet, a spark shoots out. The digital display comes on, suggesting that the scale is working properly. You should

a. avoid using the scale and apply a lockout tag. b. continue with the procedure. c. return the scale to the utility room. d. close the door in case there is a fire.

You must weigh and measure Mr. Volbrecht, a bedfast patient who is contracted in the fetal position. You will use a

a. balance scale with height bar. b. yardstick and wheelchair scale. c. ruler and electronic scale. d. tape measure and sling scale.

You will calibrate the digital scale by

a. balancing the weights. b. turning the scale on. c. standing on the platform. d. placing a weight on each side.

Ramona Bjork is a 72-year-old patient with kidney disease. She is on fluid restriction. She goes to the dialysis center three times a week. You must take her vital signs when she returns from dialysis. The care plan states that you are to weigh her daily. Her weight on Monday is 133 pounds. On Tuesday, her weight is 140. You should

a. inform the nurse of the weight gain. b. record the weight before going home. c. call the dialysis center and ask their advice. d. tell the patient she is drinking too many fluids.

When using a sling scale to weigh a patient on BEDREST,

a. raise the sling at least 3 feet above the bed. b. move the sling completely away from the bed. c. neither the sling nor the patient should touch the bed. d. hold the sling so it does not sway back and forth.

Your facility records all weights as metric values. This means you will

a. use a scale set to metric values. b. convert pounds to centimeters. c. not be assigned to do weights. d. obtain weights in meters.

Rules for Height measurement

ask pt. to remove shoes or heels, ask pt. to step onto scale carefully & support; ask pt. to stand erect; place height bar on top of head of pt. until is perfectly level, then read the measurement @ the part where the two bar parts slide together or the break in the bar record accurately.

dehydration

decreased water volume in body tissue

reasons to weigh patient

dehydration, over hydration, IV's, feeding tube, loss of weight , obesity, failure to thrive babies,cancer pts. ,vomiting, diarrhea, eating disorders, preemies, etc. and * hospital policy or Dr. orders usually to weigh ALL pts. on admission to any facility,

signs of overhydration

headache, swelling, rapid ^ in weight, ^ fontanels on baby, dizziness, ^ B/P, even death can occur

height measurement

measure recumbent until 2 years and then standing with no shoes thereafter; adult use ht. bar found on scale

Baseline

measurement of patient's vital signs or other body functions upon admission; future measurements are compared to these initial measurements to track the patient's progress

Kilogram (kg)

metric unit of weight measurement, equal to 1,000 grams or 2.2 pounds

Centimeter (cm)

one-hundredth of a meter

types of intake on a patient

oral, IV, Feeding tube, central line, ice chips, etc.

Intake and output

record of a client's fluid intake and fluid loss over a 24-hour period ;known as I&O

Balance Bar

section of an upright scale that holds the weights used to determine a patient's weight

Increments

specific amount; in measurement, the amount from one marking to the next

Pound (lb)

unit of measurement of weight, equivalent to 16 ounces or 453.6 grams

types of output on a patient

urine, BM, vomit, diarrhea, removal of fluids from procedures, blood loss, etc.