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How to Care for Your Nephrostomy Tube


About this topic


Your kidneys remove waste products from your blood to make urine. Normally, the urine drains into a narrow tube called a ureter. Then, it goes into your bladder and out of the body. Some diseases may prevent urine from leaving the body this way. ‚  
Your doctor may place a nephrostomy tube in your kidney to drain your urine to the outside of your body. ‚  

General


The nephrostomy tube is put through the skin and into your kidney. It is a short-term way for urine to leave your body. ‚  
There are a few things you need to take care of when you have a nephrostomy tube: ‚  
  • The opening in your skin where the tube exits out your body.
  • Your nephrostomy tube
  • The bag that collects the urine

The opening in your skin: ‚  
  • Your nephrostomy tube will be on your back or side. You need help when taking care of your skin.
  • Keep the open area where the tube comes out of your skin dry.
  • When taking a shower, place plastic wrap or a bag around the opening and tape it into place.
  • Clean the site each day or every other day.

Cleaning your tube site: ‚  
  • Collect all the things you need and place them on a clean table.
  • Wash your hands with soap and water.
  • Hold your tube with one hand. Remove the old bandage with your other hand.
  • Check the opening for any pus or blood before throwing away the old bandage.
  • Check your skin for redness, rash, swelling, or bad smell.
  • Dip a clean cotton tip in a cleaning agent or antibacterial soap and water.
  • Gently wipe the tip with cleaner or soap on the skin. Start from the site and work outward in a circular motion. Use a new cotton tip each time. You will do this two times.
  • If you used soap and water, wipe the soap away with a new cotton tip.
  • Pat the area dry with a clean cotton tip or gauze. Start from the site and work outward in a circular motion.
  • If your doctor gave you a drug to place on your skin, apply it.
  • Place the skin barrier around your opening.
  • Fold the bandages to make them thick. Wrap them around your tube where it enters the skin. Tape your bandages in place.
  • Place a piece of square gauze on top of your tube and wrapped bandages. Tape the gauze in place.
  • Tape the tube to your skin below your dressing for support.
  • Wash your hands.

Your nephrostomy tube and bag: ‚  
  • Drain your bag when it is halfway full.
  • Follow these steps when cleaning your bag:
    • Wash your hands with soap and water.
    • Ready a basin with warm water and antibacterial soap. Make sure the basin is big enough to let your bag soak in it.
    • Dip clean gauze in alcohol or cleansing liquid.
    • Rub the gauze on the places where your tube and drainage bag connect. Apply some pressure when rubbing.
    • Empty all the urine from your tube and bag.
    • Disconnect your bag from the tube.
    • Put your bag in the basin. Soak the whole bag with the spout open.
    • Use a syringe and push the soapy water into your bag to clean it.
    • Let the bag soak for 15 to 20 minutes.
    • Make a bleach solution while your bag soaks. To make a bleach solution, mix 1 tablespoon of clear, unscented bleach with 2 cups warm water.
    • After soaking your bag, rinse the bag with warm water. Remove all the soap.
    • Pour the bleach solution into your bag. Let the bleach solution stay inside the bag for 30 minutes to 1 hour.
    • Drain the bag of the bleach solution. Rinse it with warm water.
    • Keep the spout open and hang your bag to dry.
    • Wash your hands.
  • You may connect another drainage bag while your clean bag is drying.
  • Change your drainage bag each week or if it has a hole or crack in it. You may need a new bag if the old one becomes stiff.


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What will the results be?


You can help keep your nephrostomy tube free from infection. You can help prevent infection by keeping everything clean. ‚  

What lifestyle changes are needed?


  • Empty your urine bag and attach it to your clothes on your upper body before having sex. This may prevent accidental pulling.
  • You may still need to pass urine if your other kidney is working. Your doctor will talk with you about how your bladder will work even with a nephrostomy tube.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Help with pain
  • Prevent or fight an infection

Will physical activity be limited?


If you just had your tube put in: ‚  
  • Avoid tasks that can make you tired. Do not lift more than 10 pounds for a few weeks after your nephrostomy tube is put in. A gallon of milk weighs about 10 pounds. Slowly add to your activity with short walks, 3 to 4 times a day. Talk to your doctor about what activities are right for you.
  • Ask your doctor when or if you may return to contact sports and lifting larger objects.
  • When moving, like getting up from a chair or bed, try to make sure that your tube and urine bag are in place. Always check them for any twists or kinks.

What changes to diet are needed?


Drink 6 to 8 glasses of fluids each day. This will help to move fluids through your kidneys. ‚  

Will there be any other care needed?


  • Ask your doctor about special belts. These can help you move easily.
  • Change your position when you cannot see any urine in your drainage bag. If there is still no urine in your bag after 6 hours, call your doctor right away.
  • Make an open circle like the letter C with your tube. Then, tape the tube to your skin. This will give enough space if you accidentally pull on your tube.

What problems could happen?


  • Bleeding
  • Infection

When do I need to call the doctor?


  • Signs of infection. These include fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • Tube falls out
  • No urine in your bag for more than 6 hours

Where can I learn more?


About Kids Health ‚  
http://www.aboutkidshealth.ca/En/HealthAZ/TestsAndTreatments/Procedures/Pages/Nephrostomy-Tube-Care-at-Home.aspx ‚  
National Institutes of Health Clinical Center ‚  
http://www.cc.nih.gov/ccc/patient_education/pepubs/percneph.pdf ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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