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