home care of nephrostomy tubes

[fifi40]

I need a little help here. I have a family member getting bilateral nephrostomy tubes inserted in a few days. The only information I can find is about basic care. I need to know about things like sleeping with these tubes, the best kind of bags to get, Ive heard about belly bags, things like that. The pamphlets that are given out dont give you any hints or tips, I really would appreciate any info. THANX!

[Jay-Jay, RN]

I had 2 patients last fall with nephrostomy tubes. Usually, each tube has its own separate drainage bag. The one man chose to wear the bags as leg bags, the other tucked them into his (mesh) underpants. Neither reported any problems sleeping with the bags. The bags need to be secured somehow, to prevent any strain from coming on the tubes, and pulling them loose. Leakage from the insertion site, or from the connections in the tubes is the most common problem patients report.

Changing the dressing and flushing the tubes is a sterile procedure, requiring sterile gloves and forceps. Good skin care is a must, as urine can burn the skin, especially if the patient is on chemo. I've seen some nasty infections at the insertion sites with these tubes.

As for the type of bag, that's strictly an individual thing. You have to experiment yourself. Ask your homecare nurse what's available, and he/she may be able to let your family member try different ones. The only real differnces are the size and the type of clamp at the bottom for draining the bag.