Nephrostomy, Percutaneous Discharge Instructions

para>This is a series of images showing how to care for your wound. They include washing your hands, having the doctor take out your stitches or staples, not removing the small pieces of tape over the wound, taking care of your dressing, and watching for signs of infection like pus or redness around the wound.View Original

This is a series of images showing how to care for your wound. They include washing your hands, having the doctor take out your stitches or staples, not removing the small pieces of tape over the wound, taking care of your dressing, and watching for signs of infection like pus or redness around the wound.

View Original

What care is needed at home?

Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
You may still need to pass urine through your bladder. Your doctor will explain how your bladder will work even with a nephrostomy tube. Ask your doctor how much urine you should have in a day.
Talk to your doctor about how to care for your wound.
- Keep your wound clean and dry for the first 24 hours. Wash your hands before and after changing your bandage.
- Change your bandage each day for 2 weeks or when it gets soaked. Check to make sure that the stitches holding the tube are secure. Gently, clean the skin around the drain tube with a cotton ball soaked with water. Be careful not to pull the tube out.
- You may take a shower after 48 hours or when your doctor tells you to. Keep your wound dry when you shower. Wrap the tube and drain bag with plastic before you shower. Do this each time you shower and until the wound fully heals. You may wash your healed wound with mild soap and water during showers.
- Ask if you need to be careful with lifting things over 10 pounds.
Learn how to care for your drain tube and urine bag.
- You may have some clear to light yellow drainage around the drain tube wound for a few days. This is normal. It is also normal to see some blood in the urine drain bag for a few days.
- Always secure your tubes so they will not get pulled out. Tape them 2 inches (5 cm) below the dressing. Check the drain tube often for kinks.
Learn how to care for your drainage bag.
- When sitting or lying down, keep the drainage tube in the front of you so you don 't sit or lie on it. When moving, like getting up from a chair or bed, try to make sure that your tube and urine bag are in place.
- Always keep the drain bag below the level of your kidney to prevent urine from the tube from going back into the kidney. Urine backing into the kidney can cause a kidney infection.
- Empty your urine bag when it is full or when needed. Wear gloves when draining the urine bag. Clean the connection with alcohol or betadine. Replace your urine bag each week.
Do not soak in a tub or hot tub or swim while the tube is in place.

What follow-up care is needed?

Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
Your doctor will tell you if you need other tests.
Your doctor may ask you to measure and report the amount of urine that drains into your urine bag. Wash your hands before and after measuring the urine.
If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
Your doctor will tell you how long you need to have the nephrostomy tube.

What drugs may be needed?

The doctor may order drugs to: ‚

Prevent infection
Help with pain

Will physical activity be limited?

Avoid tasks that can make you tired. Slowly, add to your activity with short walks, 3 to 4 times a day. Talk with your doctor about the right amount of activity for you.
Ask your doctor when or if you may return to contact sports.

What changes to diet are needed?

Drink 6 to 8 glasses of fluids each day, unless your doctor tells you to limit fluids for other health problems. Drinking fluids, especially water, will help your kidneys work better. ‚

What problems could happen?

Bleeding
Infection
Kidney failure
Tube being pulled out
Tube gets blocked

When do I need to call the doctor?

Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, wound that will not heal.
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.
Urine changes color, becomes cloudy, or has a bad smell
Urine does not drain into the bag for more than 6 hours
More blood in urine than usual, or bleeding that happens all of a sudden
Leaking around the tube that soaks the bandage or is bloody
Very bad pain in your belly or back
Tube is loose or falls out
You are not feeling better in 2 or 3 days or you are feeling worse

Helpful tips

Ask your doctor about special gear or clothing for nephrostomy patients. Wear light, loose clothing for comfort to keep pressure off of the tube. This can make moving and traveling easier.
Loop your tube to form a C shape when you secure it on to your back. This can help if you accidentally pull on your tube.

Teach Back: Helping You Understand

The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚

I can tell you about my procedure.
I can tell you how to care for my cut site and any drainage tubes.
I can tell you what I will do if I have a fever, my urine has blood in it, the tube comes out, or urine stops flowing.

Where can I learn more?

KidsHealth ‚
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 ‚

Last Reviewed Date

2015-04-08 ‚

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Renal

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 provider 's 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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