1. Place the height measuring board on a hard, flat surface (preferably against a wall).
2. Provide for privacy since height can be a sensitive matter.
3. Have the child remove any footwear or headgear that may alter the measurement (including braids, barrettes, etc.).
4. Place a paper towel under child's feet if he/she is not wearing socks. Confirm that the child is standing erect with the feet together in the center of the base of the height measuring board.
5. Instruct the child to look straight ahead so that his/her line of sight is parallel with the floor.
6. Make sure the child's shoulders are level and his/her hands are at the sides.
7. Place your open left hand on the child's chin.
8. With your right hand, lower the sliding headpiece on top of the child's head.
9. Read the measurement to the nearest quarter inch.
10. Record on appropriate forms.
11. Always ask for assitance if any questions arise regarding the procedure or the findings

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1. Make sure the scales are operating correctly and set to weigh in kilograms. Ask the site coordinator for assistance if needed.
2. Provide for privacy since weight can be a sensitive matter.
3. Ask the child to remove his or her shoes and any heavy outerwear.
4. If the child is not wearing socks, have a clean paper towel ready to place on the scales. Discard after use.
5. The window will probably be blank since the scales shut off after a few minutes.
6. Tap the scales lightly with your foot. SECA should appear in the window followed by 8 and then by 0. The scales will not display the weight unless the 0's are registered when the student steps on it.
7. When the 0 appears, ask the child to step squarely on the scales and stand still.
8. When the numbers stabilize, record the weight in pounds and tenths of pounds as displayed.
9. Record on appropriate forms.
10. Always ask for assitance if any questions arise regarding the procedure or the findings

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1. Make every effort to locate this station in a quiet area.
2. Child must be sitting with arm resting on a table at the level of the heart.
3. Avoid placing the cuff over clothing or a rolled up sleeve that might constrict the arm.
4. Make sure the cuff is the appropriate size. Quick tip: Cuff width is 1/2 to 2/3 the upper arm length.
5. Palpate for brachial artery pulse point which is found in the antecubital space on the little finger side of the palm-up extended arm. Gently hyperextending the arm might make this pulse easier to find.
6. Center bladder over brachial artery with lower cuff edge 2.5 cm (1") above antecubital space.
7. Obtain palpated systolic pressure and mentally add 30 mmHg.
8. Deflate rapidly and wait 30 sec before reinflating.
9. Apply bell head making a light but airtight seal over the palpable artery. The diaphragm end may be adequate, but the bell is preferable and may help block ambient noise.
10. Inflate rapidly to level determined in step 6.
11. Release pressure 2-3 mmHg/sec. (slowly).
12. Listen for onset of 2 consecutive beats, Korotkoff Phase 1, = systolic pressure.
13. Listen for the absence of sound, Korotkoff Phase 5, = diastolic pressure.
14. Deflate cuff and remove. Record reading.
15. Always ask for assistance if any questions arise regarding the procedure or the findings.

Korotkoff Phases

1. Faint, clear tapping (Systolic)
2. Murmurs or swishing
3. Crisper, more intense
4. Distant, abrupt muffle (Diastolic)
5. Absence of sound (Diastolic)

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Acanthosis nigricans is a skin thickness and discoloration that can easily be evaluated by a simple visual examination.

Grade 1

Grade 3

Grade 2

Grade 4

Stand behind a seated child.

1. Visually examine and palpate the back and sides of the skin on the neck.
2. A positive finding is increased skin thickness with a furrowed appearance, and the affected area will be darker than the surrounding normal skin. It is not necessary to grade the finding.
3. Record findings (present or not present).
4. Always ask for assistance if any questions arise regarding the procedure of the findings.

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