It’s the end of a busy shift, and the nurse asks you for Mr. Henderson’s exact urine output. You reach for that clear, plastic cylinder with the numbers on the side—that container is called a graduate. It’s not just a cup; it’s a precision tool that tells the medical team exactly how his kidneys are performing.
What is a Graduate?
In the healthcare setting, a graduate (GRAJ-oo-uht) is a cylindrical container marked with precise measurement lines (usually in milliliters or cubic centimeters) used to measure liquid volume. While the word can mean someone who finished school, in CNA work, it refers specifically to this measuring device. It is most commonly used to measure urinary output for residents on strict Intake and Output (I&O) monitoring.
Why a Graduate Matters in Your Daily Care
Accurate measurement of fluid is critical for assessing kidney function, heart health, and hydration status. If a resident is retaining fluid or becoming dehydrated, the graduate provides the data the nurse needs to adjust medications or IV fluids. “Close enough” isn’t good enough here; a difference of 50cc could change a treatment plan. Your precision directly impacts their safety and recovery.
What You’ll See During Your Shift
You will use the graduate whenever you empty a catheter bag, bedpan, or urinal for a resident on I&O. You will place the liquid into the container, set it on a flat surface, and read the measurement at eye level. It requires focus and a steady hand.
“Hi Nurse Sarah, I just measured Mr. Henderson’s output in the graduate. He had 450cc of clear yellow urine since the last check. I’ve emptied the bag and recorded it on the I&O sheet.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Reading the measurement while holding the graduate in the air or looking down at it from above. This angle creates a parallax error, making the volume look higher or lower than it actually is.
Pro Tip: Always place the graduate on a flat, level surface (like the overbed table) and bend down to read it at eye level. Look at the bottom of the curve in the liquid (the meniscus), not the top edges, to get the most accurate number.
Memory Aid for Graduate
Think “Grad-U-At”: You Grade (measure) liquid Urine At eye level.
This reminds you that the graduate is a grading tool for urine and that eye level is the rule.
State Test Connection
This is a critical skill for the CNA clinical skills exam (usually under “Measuring and Recording Urinary Output”). You will likely be tested on accurately measuring the liquid, reading the meniscus correctly, and documenting the amount.
Related Care Concepts
Using a graduate is a central part of Intake and Output (I&O) monitoring, which tracks fluid balance. It connects to Foley catheter care because you must drain the bag into the graduate to measure output. It is also vital for monitoring dehydration or fluid overload (edema), as the numbers you record help the nurse spot these trends.
Quick Reference
✓ Key steps: Place on flat surface, read at eye level, measure bottom of curve (meniscus) ✓ When to report: Output significantly higher or lower than normal, or unusual appearance (blood, cloudiness) ✓ Care reminders: • Empty the graduate completely before measuring the next output • If feces mix with urine in a bedpan, estimate the urine portion or describe the contamination to the nurse • Record immediately so you don’t forget the number • Rinse the graduate after use to prevent odors and bacteria growth
Mastering the use of the graduate ensures that the care team has the accurate data they need to keep your residents healthy and safe.