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
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Remove stone
Biopsy lesions
Stricture dilatation
Stent placement
Allow healing of leaks or fistulas in the urethra
Site Care
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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
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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