Instructions For Care Following Nephrectomy
You have just undergone a major operation. The healing process takes time and we would like for you to observe the following instructions during your initial recovery. We have written this pamphlet for you to use as a reference during this initial healing phase.
Post-op Treatments and Instructions
During surgery a small drain may be placed. This drain is used for drainage of excess fluid from the surgical area if there is need for it. It will be removed before discharge.
You will have a foley catheter in your bladder. This will be removed on Post-operative day 1 or 2.
Pain Controlled Analgesic
You will most likely have your pain controlled by a Patient Controlled Analgesic device referred to as a PCA. This will be administered though your IV. This administers pain medication at a prescribed dosage and also at preset intervals. You will have a button to push, which can enable you to give yourself pain medication, as you need it. This monitored closely. The PCA will be discontinued on post-operative day 1 or 2. You will be given oral pain medications to keep you comfortable.
The purpose is to promote full lung expansion and prevent respiratory complications, which can affect the body temperature. This will be used throughout you hospital stay. The Respiratory therapist and the Nurse will teach instruction about use.
Sequential Compression Devices (SCD)
The purpose of the SCD is to aid circulation by providing intermittent periods of compression on the legs which is connected to a machine that has been preset to automatically give the prescribed or recommended compression pressures that are needed to prevent blood clots from forming.
Plantar Extension/Flexion Exercises
Begin with pointing your toes toward the foot side of the bed. Then point your toes up toward your face. Repeat this simple exercise at least 100 times an hour while awake.
Walking soon after surgery encourages early return bowel function, promotes effective breathing, mobilizes secretions, improves circulation, prevents stiffness of joints and relieves pressure.
The evening of, or the morning after surgery you will be instructed to get out of bed with assistance as much as you can tolerate it. The first step is to get in the chair, then you will be able to progress to walking in the halls up to six times per day.
Dressing and Suture Line
Your dressing and suture line will be over the area where your kidney has been removed. Your physicians and nurses will check this daily. The suture line can be kept clean with soap and water.
The first day after surgery you will receive clear liquids and will advance to regular diet as you tolerate it.
Instructions After Discharge
Continue walking when you return home.
- The walking will help you build strength. Gradually increase the amount of walking you do each day. Take planned rest periods during the day. The best gauge is your own body and how you feel. It is very important that you continue walking when you are discharged from the hospital. Not only will this build strength but will also aid in preventing blood clots from the legs.
- If you must pick something up, bend with your knees, not your waist: stoop to pick up the item.
Avoid heavy lifting.
- (Greater than 5 pounds) Anything you need to brace yourself to pick up is too heavy. Also avoid strenuous activity.
Stairs should not be a problem.
- Take them slowly at first. You may wish to group your activities, so that you do not have to make many trips up and down stairs during the first week you are home.
Driving should be avoided
- Driving should be avoided for at least 4 weeks after surgery or until you are not taking pain medications or are pain free. Take breaks every couple hours if you are on extended trips. Get out of your car and walk around a bit.
- Do not drive any motorized vehicle, or sign any legal documents while you are taking pain medications. The medications may alter visual perception and impair judgement.
Bathing/taking a shower will be ok
- Gently wash the incision with soap and water, rinse well, and pat dry. So do not take a tub bath until the incision is completely healed.
- If you had an open nephrectomy you will have white strips called “steri-strips” on the incision. They will fall off in about a week.
- A well balanced diet is encouraged to promote healing and good bowel function. Return to your normal fluid intake.
- If you become constipated, there are alternatives to consider. Increase the roughage in your diet. Drink prune juice or orange juice. You can take an over the counter laxative of your choice. Colace will be prescribed when you are discharged. Drink 6-8 glasses of water per day.
Reasons to Call the Physician
- Your incision becomes red or swollen
- The skin around your incision is warmer than elsewhere and is slightly red
- There is drainage from your incision
- There is an opening in your incision
- You are having difficulty passing urine or your urine output becomes less than it
normally has been
- There are chills or fever of 101 or more
- Severe pain that is not relieved by pain medication
For Urgent or Emergent situations 24 hours a day, page the Urology Resident on call at 734.936.6267. They will contact the physician for you.