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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Radiology - Invasive Procedures

Percutaneous Nephrostomy Drainage – Interventional Radiology (4527)

Percutaneous Nephrostomy Drainage – Interventional Radiology (4527) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Radiology - Invasive Procedures

4527






Percutaneous Nephrostomy Drainage
Interventional Radiology


What Is a Percutaneous Nephrostomy Tube?

A percutaneous nephrostomy tube is a small, soft plastic tube. It enters the skin in the side of
your lower back to drain urine from the kidney. The purpose of this tube is to relieve pressure in
the kidney from urine that has backed up into it. This tube is placed for many reasons. Most of
the time, there is some type of blockage that prevents urine from draining out of the kidney into
the bladder.

You will be required to spend the night in the hospital following the initial placement of the tube.
Once in place, a nephrostomy tube needs to be changed every 6-8 weeks to make sure the tube
keeps draining well. Nephrostomy tube changes are done as an outpatient. .


How is a nephrostomy tube placed?

. Placement of the tube is done using:

Ultrasound; to create pictures of your organs and
record the echoes of sound waves

Fluoroscopy; an exam of your organs by means of x-
rays

Before the tube placement, an Interventional Radiologist
will explain what is going to happen and ask for your
consent to do it. Please tell the doctor if you have any
allergies to contrast dye, antibiotics, anesthetic (numbing)
agents, latex, or any other medicines that you may have
taken before.


An intravenous (IV) catheter will be placed in your hand to give you medicines for pain and to
relax you. IV antibiotics are also given.

Using ultrasound and fluoroscopic guidance, the doctor will mark your lower back with a special
magic marker. This helps plan where to place the tube. After marking this area, the skin will be
cleaned with a special soap. A sterile drape will be placed over your back and legs. The doctors
will put on sterile gowns and wear masks.

A local numbing agent (1% Lidocaine) will be injected into the skin of your flank or lower back
in order to numb the area so you won’t feel the needle go in. You will begin to get medicine to
relieve the pain and help relax you. Most of the time, patients do not feel much pain, but you
may feel pressure during the placement.

Once the area is numb, the doctor will put a small needle into the kidney through the skin of your
flank or lower back. When it is in place, a small amount of x-ray dye will be injected in order to
see your kidney and urinary system. The needle will then be replaced with a soft tube that stays
in the kidney.
















The other end of the nephrostomy tube will remain outside your body to drain urine into a bag.
The tube is secured into place at the skin surface with a stitch. After this, a 2 x 2 gauze will be
placed under the tube and then a 2 x 2 gauze will be placed on top of the tube. Then a 4 x 4
Tegaderm dressing will be placed over the gauze. On average the procedure will take 1-2 hrs.


After the Procedure

1. You will return to a hospital room. .
2. The nursing staff will be checking your
vital signs such as pulse, blood pressure
and temperature.
3. Nurses will watch how your tube is
working. They will check the amount
and color of your urine. It is okay if
your urine appears blood tinged, this
is normal. It will clear up over time.
4. You should tell the nursing staff if you:
ξ feel nauseated
ξ vomit
ξ feel like you have a fever or have
chills
ξ have severe pain where the tube goes
in
ξ have any problems breathing

Home Care of Your Nephrostomy
Tube

Supplies you will need:
4 x 4 Tegaderm
2 x 2 sterile gauze
Mild soap( ie: Dove)Blue caps for
flushing the tube

Steps to Clean the Tube and Change the
Dressing:

The tube site must remain free of bacteria that
could cause an infection at the site.
ξ If using Tegaderm , the dressing is
changed every 3 days.
**If your skin is too sensitive for
Tegaderm then a 4 x 4 or 2 x 2
sterile gauze can be used with tape.
ξ If using 4 x 4 or 2 x 2 sterile gauze,
the dressing should be changed once a
day.
1. Gather all supplies needed.
2. Wash hands well with soap and water for
30 seconds.
3. Remove the old dressing.
4. Check the tube site for
▪ increased tenderness or pain
▪ increased redness or swelling
▪ drainage that is green in color or
smelly – small amount of green
drainage is normal
▪ sutures at the skin site that are loose
5. Using a clean wash cloth, clean the skin
around the tube site with soap and water.
Gently scrub the skin around the exit
site. Rinse with wet wash cloth. Wipe
dry. Allow the area to dry completely
before putting the dressing on.
6. Place the Tegaderm dressing or sterile 2
x 2 gauze under the tubing and then
place the additional 2 x 2 gauze over the
tube insertion site.
7. Tape down the nephrostomy tube at the
level of your hip. This helps prevent the
tube from being dislodged.

Additional Instructions If your
Nephrostomy Tube Is Connected to
a Drainage Bag

If your tube is connected to a drainage bag,
urine made by the kidney will drain into the
bag. If your other kidney is working, you
will urinate in the usual manner. Do not be
alarmed if you urinate less or not at all.

The extension tubing and drainage bag will
be changed when you come to the hospital
for a routine change. You may need to
change these before your visit. Reasons to
change the tubing and bag are if the bag or
tubing has a foul odor or a lot of build up
inside.

Supplies you will need:
Urine Leg Bags
Nephrostomy Extension Tubing (CTU-30)

1. Gather all supplies needed.

2. Wash your hands well with soap and
water for 30 seconds.
3. Connect the new urine leg bag to the
tubing.
4. Unscrew the clear tubing from the
nephrostomy tube in your back.
5. Discard the old tubing and bag.
6. Connect the new tubing and bag by
screwing the clear extension tubing back
onto the nephrostomy tube.


If your Nephrostomy Tube Is
Clamped

No urine will drain from the tube if it is
clamped off. There will be no drainage bag
on your tube. Urine made by your kidney
will drain through the ureters and down into
your bladder and will leave your body when
See Heath Facts for you #5721, Flushing
Your Drain.

When to Call the Doctor

Call the doctor if you have:
▪ Redness at the site
▪ Greenish drainage at the site
▪ New swelling at the site
▪ A temperature greater than 100.5 θ F
for two readings taken 4 hours apart
▪ Shaking chills.
▪ Foul-smelling urine
▪ Decreased urine output from your
drainage bag
▪ Cloudy urine with a sediment
▪ Pain at your tube site
▪ Pain in your side.
▪ Your stitches come out or break.
you urinate.







Phone Numbers

If you have any questions or problems once you are at home, call:

Radiology Department, Monday through Friday, 8:00 am to 4:30 pm at
(608) 263-9729, option #3

Nights, weekends, and holidays call (608) 262-2122. This will give you the paging operator.
Ask for the Interventional Radiologist on call. Give the paging operator your name and phone
number with the area code. The doctor will call you back.

If you live out of the area, please call 1-800-323-8942.


Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©9/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF4527.