21. CCA Study Notes: Measuring Height and Weight Safely and Accurately

The Big Picture

Height and weight measurements need consistency. Small differences in clothing, timing, positioning, or equipment can change the result.

The main goal is to measure the client as accurately as possible while protecting safety, privacy, dignity, comfort, and independence. Different clients need different types of scales or different ways of measuring height.

Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.

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Course Notes: Key Ideas You Need to Know

Why Consistency Matters

Height and weight may be measured daily, weekly, or monthly as part of a client’s care plan.

Some clients need daily weight measurements when there is concern about fluid retention or when weight gain or loss needs monitoring.

For consistent weight measurements:

• Weigh the client at the same time of day.
• Use the same scale.
• Weigh the client in the same clothing.
• Before breakfast is the best time.
• Have the client void before weighing.

Food, fluids, clothing, footwear, and a full bladder can affect weight measurements.

The client should wear only a gown or pyjamas when being weighed. Shoes and slippers affect both weight and height measurements.

If a urine specimen ⓘ is needed, it can be collected when the client voids before weighing.

Protect the Client During Measurement

Throughout height and weight procedures, promote:

• dignity
• independence
• individualized care ⓘ
• preferences
• privacy
• safety

Explain the procedure before starting and provide privacy.

Types of Scales

Several types of scales are used for different client needs.

Balance Beam Scale

A balance beam scale is used for clients who are able to stand.

The scale uses movable weights and a balance pointer. The pointer must be in the middle for an accurate reading.

Standing Digital Scale

A digital scale displays the weight on a screen.

Digital scales use an LED, or light-emitting diode, display. Make sure the display reads zero before weighing the client.

Chair Scale

Chair scales are used for clients who cannot stand.

The client sits securely in the scale chair while the weight appears on the screen.

Lift Scale

Lift scales are used for clients who cannot stand.

A sling supports the client while the scale measures the weight.

Wheelchair Scale

Wheelchair scales are used for clients who use wheelchairs.

Bath Chair Scale

The weigh scale in a bathtub lift chair is the most common type used in facilities.

Always follow the manufacturer’s instructions and employer policy ⓘ when using scales.

Converting Pounds to Kilograms

Some clients in the community have scales that use pounds instead of kilograms.

To convert pounds to kilograms:

Number to remember: Divide the number of pounds by 2.2.

Examples:

• 10 lb = 4.5 kg
• 160 lb = 72.7 kg

Measuring Height and Weight With a Balance Beam Scale

Before the Procedure

Complete these steps in order:

1. Identify the client according to employer policy.
2. Explain the procedure to the client.
3. Ask the client to void. A full bladder affects the weight measurement.
4. Perform hand hygiene.
5. Collect the scale and paper towels.
6. Provide privacy.

Using the Balance Beam Scale

1. Perform hand hygiene.
2. Disinfect the scale platform according to employer policy. Dry it with paper towels. This reduces the risk of spreading pathogens.
3. Raise the height rod before the client stands on the scale. This helps prevent accidental injury.
4. Move the weights to zero. Check that the pointer rests in the middle.
5. Have the client remove their robe and footwear. Assist as needed. Clothing and footwear can add weight.
6. Help the client stand on the scale platform with their arms at their sides. The client should not hold on to anything because this can affect the weight measurement.
7. Move the weights until the balance pointer rests in the middle.
8. Ask the client to stand very straight. This keeps the weight balanced on both feet.
9. Record the weight on your notepad or assignment sheet. Recording it right away reduces reliance on memory when transferring the measurement to the client’s record.
10. Lower the height rod until it rests on the client’s head. The rod must touch the head rather than only the hair.
11. Record the height on your notepad or assignment sheet.
12. Disinfect the scale platform after use according to employer policy.

Measuring Weight With a Standing Digital Scale

Follow these steps in order:

1. Perform hand hygiene.
2. Disinfect the scale platform according to employer policy. Dry the scale according to employer policy.
3. Raise the height rod before the client steps onto the scale if the scale has one.
4. Turn on the scale and make sure the display reads zero.
5. Have the client remove their robe and footwear. Assist as needed.
6. Help the client stand on the platform with their arms at their sides.
7. Make sure the client does not hold on to anything.
8. Read the weight shown on the screen.

Clothing, footwear, and holding on to something can affect the measurement.

Measuring Weight With a Bath Scale or Chair Scale

Follow these steps in order:

1. Help the client transfer from the wheelchair to the chair scale. Ask for assistance if necessary. Assistance reduces the chance of a fall.
2. If the client will be weighed before a tub bath, help the client move directly from the bed to the bath chair after undressing. Cover the client with a blanket or bath blanket.
3. Make sure the client is secure and is not holding on to anything that might cause a false reading.
4. Read the weight shown on the screen.
5. Record the weight on your notepad or assignment sheet.

Weighing the client immediately before a tub bath reduces extra time and steps and is less tiring for the client.

Measuring Weight With a Lift Scale

Follow the steps in the correct order.

1. Attach the sling to the lift according to the manufacturer’s instructions.
2. Place both weights at zero.
3. Level and balance the scale according to the manufacturer’s instructions.
4. Remove the sling from the scale so it can be placed on the client.
5. Place the client on the sling and attach the sling to the lift.
6. Raise the client about 10 cm (4 in.) off the bed.
7. Move the weights until the balance pointer rests in the middle.
8. Record the weight on your notepad or assignment sheet.
9. Lower the client back onto the bed.
10. Remove the sling.

Safety: Do not raise the sling higher than needed. Raising it too high increases the client’s risk of injury if a fall occurs.

The sling can also be uncomfortable for the client, so lower the client back to the bed after obtaining the measurement.

After Measuring Weight or Standing Height

After the scale procedure:

1. Help the client dress if the client is up, or help the client return to bed.
2. Provide for safety and comfort.
3. Place the call bell within reach when this step applies.
4. If the client stays in bed, follow the care plan for bed rail use when this step applies.
5. Remove privacy measures if used.
6. Return the scale to its proper place.
7. Perform hand hygiene.

Keeping the call bell within reach gives the client a safe way to contact staff when necessary.

Following the care plan for bed rail use reduces the risk of a fall.

The call bell and bed rail steps may not apply in community settings.

Reporting and Recording Height and Weight

Report and record: Record the measurements and your observations according to employer policy.

Report any unusual measurement immediately to your supervisor.

Actions, observations, and basic assessments are recorded and reported for legal reasons and to keep the rest of the health care team informed.

Measuring Height When the Client Is in Bed

When a client’s height is measured in bed, the procedure uses a measuring tape and ruler.

This procedure requires two people to obtain an accurate measurement.

Before the Procedure

1. Identify the client according to employer policy.
2. Explain the procedure to the client.
3. Perform hand hygiene.
4. Collect a measuring tape and ruler.
5. Ask for assistance. Two people are needed for an accurate measurement.
6. Provide privacy.

Correct client identification prevents one client from being mistaken for another.

Measuring the Client

1. Perform hand hygiene.
2. Have the client lie in the supine position if this position is allowed.
3. Have your helper hold the end of the measuring tape at the client’s heel.
4. Pull the measuring tape alongside the client’s body until it extends past the head.
5. Place the ruler flat across the top of the client’s head.
6. Extend the ruler from the client’s head to the measuring tape.
7. Make sure the ruler stays level.
8. Record the height on your notepad or assignment sheet.

The tape measures the client’s height as if the person were standing.

The ruler must stay flat and level. If it is not flat, the measurement will not be accurate.

Recording the measurement right away supports accurate transfer of the height to the client’s record.

After Measuring Height in Bed

1. Provide for safety and comfort.
2. Place the call bell within reach when this step applies.
3. If the client stays in bed, follow the care plan for bed rail use when this step applies.
4. Remove privacy measures if used.
5. Return the equipment to its proper location.
6. Perform hand hygiene.

The call bell and bed rail steps may not apply in community settings.

Report and record: Record the height and your observations according to employer policy.

Report any abnormal reading immediately to your supervisor.