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A
few more important preparations of the client help to ensure accurate and
reliable results.
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Skin where the electrode
will be attached should be clean and dry. If a client has been perspiring,
try to do any general counseling first before performing the BIA. By the
time their heart rate returns to normal, they will be ready for the BIA.
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Electrode position is imperative
for the wrist and ankle. The exact placement on the hand near the fingers
and foot near the toe is less crucial. Determine where you will place the
electrodes, and follow that procedure each time you perform the test.
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Wrist placement: the top
edge of the pad should be placed on an imaginary line bisecting the ulna
head (bone on little finger side of wrist).
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Ankle placement: the top
edge of the pad should be placed on an imaginary line bisecting the medial
malleolus (bone on big toe side of ankle).
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When it comes to determining
which side of the body receives the electrodes, new evidence indicates
that it isn’t a significant factor. Electrode placement can be entirely
on either the right or left side of the body, or placed on both sides of
the body (for instance, hand electrodes on the right and foot electrodes
on the left). For standardization purposes, the right hand side of
the body should be used whenever possible. Any changes to that method
should be noted and used in follow-up monitoring, if appropriate.
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Since food, urine, and gastrointestinal
contents are in external compartments compared to the internal compartments
containing fluid, lean body tissue and fat, it doesn’t matter if a person
goes to the bathroom prior to or after the BIA is performed. A full bladder
or recent meal may change weight, but is unlikely to be significant in
changes to body cell mass (BCM). Silicone implants that are wholly contained
will only add weight and not change the readings significantly.
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If a client is wearing jewelry,
they can keep it on if it is at least one inch away from the electrode.
Bracelets or watches can either be slid further up the arm or removed.
Be especially careful to clean off lotion, sweat, or oil (including petroleum
jellies) that may be on the skin leading to metal jewelry. If there
is any metal inside the body (excludes all piercings), the results may
be varied only slightly. Document in your records if metal is present inside
the body.
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Question: Can I save
money by cutting the electrodes in half?
Answer: Yes. To
get accurate results, all of the teeth on the alligator clips must be attached
to the non-sticky tab of the electrode. Depending on the type of electrode
you are using, the pad size may vary. Therefore, some pads might lend themselves
to be cut more easily than others. The results will not be skewed if you
cut the pad to reduce the size of the adhesive. You should
assure that the pad has a good connection with clean, dry skin, whatever
its size.
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