Your child is going home with a nephrostomy tube. The tube needs care at home. A nurse will teach you how to care for the
tube before your child leaves the hospital.
What is a nephrostomy tube?
A nephrostomy tube is a small tube that drains urine from your child's kidney to the outside of your child's body. It is also
called a nephrostomy catheter.
The place where the tube comes out of your child's body is called the exit site. When your child leaves the hospital, the
exit site will be covered with a dressing.
Problems that require medical attention
There can be problems with the nephrostomy tube that you should not try to solve by yourself. Call your child’s urology clinic
or hospital right away if any of the following things happen:
-
The tube comes out. Do not try to put the tube back in yourself.
-
There is a change in urine colour. It is normal for the urine to be a little pink from small amounts of blood. If there is
a further reddening of colour, call your child's urology clinic.
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Less urine is coming out of the tube. Normally, you should see a slow, continuous flow of urine. If less urine is coming out
of the tube, flush the tube and then call the urology clinic.
-
Your child develops
fever or chills. This could be a
sign of
infection.
Care of the nephrostomy tube
Your child's nurse will show you how to care for the tube before your child goes home from hospital. If you are not shown
how to care for the tube, ask the staff at the urology clinic.
To care for your child's nephrostomy tube, follow these instructions:
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Wash your hands well with soap and water before and after you touch the tube or urine.
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Check the catheter tubing every hour for leaks, loops, or kinks.
-
Always keep the catheter drainage bag lower than your child’s
bladder.
-
Empty the drainage bag regularly.
Changing the dressing
Nurses usually change the dressings on a nephrostomy tube, but if you have been taught how to do it and you are comfortable,
you can change the dressing yourself.
Every 3 days, or if the dressing is wet, you should change the dressing on the exit site. To change the dressing, follow these
steps:
-
Cleanse the exit site with a cleansing solution such as Betadine. If you do not have a cleansing solution, you can use soap
and water.
-
Rinse with clean water.
-
Cover the site with gauze. Stick the gauze in place with tape.
Three days after the nephrostomy tube is put in, if there is no drainage of urine or other fluids from around the tube, you
can stop putting dressings on the exit site. This is more likely to happen with older children.
Flushing the nephrostomy tube with normal saline
If the flow of urine from the tube decreases or stops, the tube may need to be flushed with a salt water solution called normal
saline (NS). This clears any small pieces of waste that might be blocking the catheter from draining. Flushing is also called
instilling.
To flush the tube, follow these steps:
-
Clean the connection between the nephrostomy tube and the drainage tubing with an alcohol swab.
-
Pinch the nephrostomy tube between your thumb and forefinger. Disconnect it from the drainage tubing. Set the tubing end to
the side on a clean paper towel.
-
Attach the
syringe of normal saline to the end of the nephrostomy tube. Gently push the plunger to fill the catheter with
the normal saline solution. If you meet resistance and the saline solution does not flow, see the instructions below.
-
Once the normal saline is all in, remove the syringe. Reconnect your child’s nephrostomy tube to the drainage tubing. The
normal saline will drain out on its own.
If you meet resistance
If you meet resistance while you are pushing the plunger and the saline solution does not flow, follow these steps:
-
Check the tubing for kinks and try again.
-
If there is still resistance, reconnect the tubing to the nephrostomy tube. Watch for a good flow of urine.
-
If urine does not flow, call your child’s urology clinic.
Do not pull the saline out of the tube with the syringe
Flushing a nephrostomy tube is not the same as irrigating it. Irrigation is putting normal saline into the tube and then pulling
it out with a syringe. Never do this yourself. Irrigation should only be done by a doctor or a nurse.
Your child can have a bath or shower
Your child can have a bath or shower with a nephrostomy tube. After the bath or shower, change the dressing right away.
Key points
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Nephrostomy tubes require regular care at home.
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Parents can learn how to do regular maintenance of the tube.
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Parents may instil or flush a nephrostomy tube. However, only a professional should irrigate a nephrostomy tube.
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