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Nephrostomy tubes

Care and feeding. Nephrostomy tubes. Purpose of placement. 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

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Nephrostomy tubes

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  1. Care and feeding Nephrostomy tubes

  2. Purpose of placement 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

  3. Untreated Obstruction Hydronephrosis Pyelonephritits Pain Sepsis Impairment in renal function

  4. Nephrostomy Usage Temporary use in treatment of Stricture or Calculus Permanent use with an obstructing tumor, may be indefinite

  5. May use nephrostomy tube to Remove stone Biopsy lesions Stricture dilatation Stent placement Allow healing of leaks or fistulas in the urethra

  6. Site Care 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.

  7. Assess Skin Around Tube Irritation Drainage Infection

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

  9. Patient Education after placement 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.

  10. Nephrostomy Tube Irrigation 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

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