Definition
Checking a patient’s height and weight is a fundamental nursing procedure that provides essential data for medication dosing, nutritional assessment, and fluid balance monitoring.
Purposes
- To assess fluid balance in patients with fluid retention, renal problems, and cardiac problems.
- To assess the response to therapy, e.g., diuretics.
- In ascertain the response to physiological changes or prescribed diet, e.g., pregnancy, high calorie diet.
- To obtain baseline data about a patient’s health status, especially nutritional status, and body mass index (BMI).
Articles
- Weighing machine (electronic weighing scale) or sling scale
- Measuring tape
- Ruler
Procedure
| Nursing action | Rationale | |
| 1 | Assess the patient’s ability to stand independently on the weighting machine Checking of weight while standing on electronic scale: | Ensures safety of the patient while checking weight and height. |
| 2 | Wash hands | Reduces transmission of microorganisms. |
| 3 | Explain the procedure to the patient and ask patient to void. Instruct patient to wear a hospital gown, or a light weight clothing. Ask the patient to remove shoes and then step on the scale and stand erect and still. | Helps to gain cooperation of the patient. Voiding reduces the weight of urine in the bladder. Extra clothing will cause errors in reading of weight. |
| 4 | Place the weighing machine near the patient. | Reduces risk of fall/injury. |
| 5 | Turn on the scale and calibrate it to zero. | Ensures accurate reading. |
| 6 | Instruct the patient to step on the scale only after the digital display shows zero. | Ensures accurate reading. |
| 7 | Read weight after digital numbers stop fluctuating. | Reading in not accurate when numbers are still fluctuating |
| 8 | Ask the patient to step down and assist the patient back to bed or chair. | Reduces risk of injury |
| 9 | Wash hands. | Reduces transmission of microorganisms |
| 10 | Checking of weight in a sling scale: A sling is placed under the patient carefully without any fold | More accurate weight will be obtained by leaving no bedding between the sling and the patient. |
| 11 | Switch on the scale and calibrate it to zero. | |
| 12 | Lower the arms of the sling scale and slip hooks through the holes of the sling. | This is to attach the sling to the scale to measure the weight. |
| 13 | Pump scale until sling completely lifts off of the bed. | Ensures accurate weight reading |
| 14 | Read weight after digital numbers have stopped fluctuating | Reading to not accurate when numbers are fluctuating |
| 15 | Lower the sling arms and place the patient comfortably on the bed. | Ensures patient comfort. |
| 16 | Measuring height: Ask the patient to remove the shoes. | Ensures accurate checking of height |
| 17 | A measuring tape can be held or attached to the wall vertically. | |
| 18 | Instruct the patient to stand erect, with heels together. | Helps in obtaining accurate measurements. |
| 19 | With ruler placed horizontally on the head at 90° angle to the measuring tape, the height is measured in inches/cm. | |
| 20 | Provide the patient a comfortable position in the bed. | Ensures patient’s comfort |
| 21 | Replace the articles. | |
| 22 | Wash hands. | Reduces transmission of microorganisms. |
| 23 | Record the procedure with date, time, height and weight | Documentation helps in continuity of care. |
Special Consideration
- Weigh the patient at the same time with same amount of clothing each day to get accurate readings.
- Preferably, use the same weighing scale while weighing patients daily.
- Weighing machine with attached scale for measuring height can be used to measure height and weight simultaneously
Paediatric Variations
- Daily weight recording ensures monitoring of adequate nutrition and fluid balance.
- It is an essential indicator of growth and development. In case of low-birth-weight newborns at 2 weeks (to check regaining of weight), 4 weeks (to ascertain a weight gain of 80-100 g/kg per week) and then every month.
- It is an essential indicator for fluid imbalance especially in sick new-born and very low birth weight(<1500g) babies who require daily monitoring of fluid therapy for at least 1 week.
- If a baby loses or gains 3% or more of body weight in a day it should be notified to the physician.
- Record weight prior to feeding and after voiding.
- Ask mother to dress baby promptly after weighing to prevent hypothermia.
- Tarred weighing: It involves the scale to be re-set to zero (“tarred”) with the person (mother) just weight still on it.while remaining on the scale, the mother can be given her child to hold, and since the scale is tarred only appears on the scale is tarred only the child’s weight alone appears on the scale.
Advantage of tarred weighing:
- No need to subtract weight to determine child’s weight alone
- Child remains calm throughout the assessment due to undisturbed comfort of mother’s warmth.
8. instrument used for measuring:
- Weight in infant/neonates- weight scale
- Height in infants is measured using infant meter
- Height of child is measured using portable /wall mounted Harpenden stadiometer with movable head piece
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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