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
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
 Change once weekly or if dressing becomes soiled.
Assess Skin Around Tube
 Irritation
 Drainage
 Infection
Notify Physician if
Flank pain
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

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