Nephrostomy tubes Care and feeding

To provide urinary drainage through a tube inserted into the renal pelvis

Tub exits from the flank and is attached to extension tubing which drains to a leg bag

Designed to divert the drainage away from a partial or complete obstruction of the urinary tract

Purpose of placement

Hydronephrosis

Pyelonephritits

Pain

Sepsis

Impairment in renal function

Untreated Obstruction

Temporary use in treatment of Stricture or Calculus

Permanent use with an obstructing tumor, may be indefinite

Nephrostomy Usage

Remove stone Biopsy lesions Stricture dilatation Stent placement Allow healing of leaks or fistulas in the

urethra

May use nephrostomy tube to

Remove original dressing when becomes old Keep skin around tube dry Clean with wound cleanser or soap and water Place gauze, sponge and cover with Occlusive

dressing.

Change once weekly or if dressing becomes soiled.

Site Care

Irritation Drainage Infection

Assess Skin Around Tube

Fever Chills Flank pain Sweats Leakage around the tube Tube dislodgement Inability or difficulty irrigating the catheter Absence of drainage from the tube

Notify Physician if

Tubes need to be changed every 2 to 3 months. Patient should be instructed in the importance of follow up.

Prevent tension on the tube Cleansing of the skin around the tube Significance of adequate fluid intake to promote

drainage and prevent urinary tract infections Procedure for changing the dressing around the

tube Disinfection of overnight bag Literature inconsistent on bag change frequently,

generally once a week.

Patient Education after placement

May be ordered to clear tube of sediment, debris, or blood clots

Use 5 to 10 ml. of normal saline Insert gently or according to the preference

of the health care provider Do not force fluid in Do not withdraw

Nephrostomy Tube Irrigation