Instructions For Care Following Percutaneous Nephrostomy
Activity-gradually increase activity with short frequent walks, three to four times a day.
Avoid strenuous activities, like sports, lawn mowing, or heavy lifting, more than ____
pounds. Wear loose, comfortable clothing that won’t pull or kink the tube or tubes.
Check the dressing often to make sure the tubing is securely taped in place to avoid
pulling on or kinking it. Do not drive while taking pain medication, or until your doctor
permits it. Wait to resume sexual activity until after clinic visit, unless your doctor
Bathing and dressing change. You may shower unless otherwise instructed. Do not
soak in bathtub.
Gather all you dressing supplies before you shower.
Securely cover the tube and insertion site with a layers of saran wrap taped into place,
then you may shower. Change the dressing after you shower. Remove the saran wrap
and used dressing carefully so you don’t pull on the tube. Discard the dressing in plastic
Gently clean around the insertion site with liquid soap (like Dial) and warm water, rinse
thoroughly, and pat dry with a clean towel. Check the insertion site and the skin area
around it for any signs of increased redness, temperature, swelling, pain tenderness,
bleeding, foul drainage, or urine leakage Do not apply ointment or alcohol to the
site, just keep it clean and dry. Apply the clean dressing.
Change_______________________, or if the dressing becomes loose or soiled.
Apply the drain sponge (a 4 by 4 with a slit) carefully and cover with a regular 4 by 4
dressing. Tape the tube securely to you skin as well as the dressing.
Change ________________________, or if the dressing becomes loose or soiled.
Tube and drainage bag care.
Always make sure the tube is taped securely and do not let the drainage bag hang freely
to pull on the tube. Pin the bag to your clothing being careful not to puncture the bag or
tubing. If the tubing has a white plastic stopcock, make sure it is open and draining
into the bag. Measure and record the amount and color of the urine and notify your
doctor if the amount increases or decreases markedly _______. Notify your doctor
if the urine changes to a pink or red color. Use graph on the back of this page.
Wash your hands before and after emptying the drainage bag. Empty the drainage bag
when it is ½ to 2/3 full, and before going to bed. If you have a considerable amount of
drainage and need empty the bag more often than__________, you may want to wear a
leg bag during the day and a foley drainage bag at night. Consult with your doctor.
When drainage bag is not in use, make sure the tubing end is covered with the cap that is
included with the bag, this reduces the chance of an infection developing. Mix a solution
of one part of white vinegar with an equal part of warm water, and flush the bag and
tubing with it once a day. Drain the solution into the toilet.
You may resume your former diet unless instructed otherwise. Drink plenty of liquids,
especially water. About six 8 ounces of liquid a day. If you had a kidney stone treated,
this will help flush the residue from your system.
Notify your doctor
If the nephrostomy tube is not draining. Check carefully, first, to make sure the tubing
is not kinked, the stopcock is open, and the tube is not clogged or dislodged. If the tube is out, call the doctor right away.
If you develop nausea and vomiting and cannot tolerate your medicine. Let the
doctor know if you have missed any doses of medicine.
Any increase or change in you pain, especially if you develop severe pain in you side.
Take your oral temperature every morning, and report a temperature of___ or
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.