Obtaining weights

Steps

Prior to weighing a patient, check the scales for accuracy. Take the patient to a private weighing area or take a bed scale to patient’s room.

Scale: standing (ambulatory patient)

• Explain the procedure to patient
• Have the patient remove their shoes
• Place a paper towel on the scale platform
• Perform hand hygiene
• Help the patient to stand on scale without touching or holding on to anything.

Digital scale

• Make sure display reads ‘0’ before the patient steps on scale
• Read the display with patient still standing still on the scale.

Upright balance (gravity) scale

• Move the large lever until the balance beam pointer sinks to the bottom
• The large lever may be placed on 50 lbs, 100 lbs, 150 lbs, 200 lbs, etc
• Move the small lever until the balance beam pointer rises to the center
• The small lever may be placed on any number between 1 and 50 lbs
• Once balance beam pointer rises to center, add up the weights from weight marker of larger and small levers. For example – 100 from larger lever and 21 from small lever = 121 lbs.

Scale: chair, wheelchair, or bed (non-ambulatory, acutely ill, debilitated patient)

• Follow the manufacturer’s instruction manuals.

To assist in determining weight loss or gain, utilize specific tools.

• BMI = body massindex = height to weight ratio (See Resources: BMI Index Table 1)
• BMI and waist size = excessive abdominal fat can increase risk of obesity-related medical conditions (e.g. type 2 diabetes, arterial disease, high blood pressure) [See Resources: BMI calculator Table 2]

Table 1.

Body mass Index

Table 2.

Body mass index (BMI) calculator risk of associated disease according to BMI and waist size

Source: Howard ¹

Involuntary weight loss (IWL) = non-specific symptom very common in older adults and those with chronic or subacute diseases due to high metabolic demands

• IWL parameters are key indicators of nutritional status, including risk for malnutrition and possible significant health risks
• 5% weight loss in 30 days (1 month)
• 7.5% weight loss in 90 days (3 months)
• 10% weight loss in 180 days (6 months)

It is important to document the patient’s weight in their medical record (EMR). Maintain accurate records or chronological weight. If weight increase (according to parameters for IWL or BMI calculations) or rapid weight loss are observed, this may indicate diuresis or fluid retention, respectively. The health professional should investigate further and notify the patient’s physician or provider of weight change allowing for appropriate interventions.

Key points

• Staff should be trained in standardized patient weight protocol.
• Scales should be checked for accuracy at least weekly, calibrated as needed, and results documented on specific form.
• Weight protocol
• – Same scale, same time of day, same clothing
• – Center patient on the scale
• – Instruct patient to avoid movement
• – Make sure scale is not resting on nearby objects.