Nephrostomy tubes
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Transcript 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
Designed to divert the drainage away from a partial or
complete obstruction of the urinary tract
Untreated Obstruction
Hydronephrosis
Pyelonephritits
Pain
Sepsis
Impairment in renal function
Nephrostomy Usage
Temporary use in treatment of Stricture or Calculus
Permanent use with an obstructing tumor, may be
indefinite
May use nephrostomy tube to
Remove stone
Biopsy lesions
Stricture dilatation
Stent placement
Allow healing of leaks or fistulas in the urethra
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.
Assess Skin Around Tube
Irritation
Drainage
Infection
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
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.
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