12. The correct nursing action for a client who has a nephrostomy tube would include:
. Attaching tube to suction prn with low urine output.
. Changing the bandage and drainage bag daily.
. Irrigating, if ordered, with no more than 10 mL sterile NS.
. Clamping and unclamping the tube at hourly intervals.
Test-Taking Tip
Think of an action that keeps a tube patent.
Content Area: Adult Health, Renal; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems
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Answer 1 is incorrect because urine production is dependent on volume status and kidney function. Suction cannot be used to create more urine output. Answer 2 is incorrect because the dressing is changed weekly unless wet, and the bag is emptied when half to two thirds full. Answer 3 is correct because a nephrostomy tube is inserted into the ureter, directly draining the kidney. The pelvis of the kidney cannot accommodate volumes greater than 10 mL. The procedure must be sterile. Answer 4 is incorrect because, unless there was ureteral flow around the nephrostomy tube, it would be dangerous to clamp the tube. Urine backing up in the kidneys could cause hydronephrosis and infection.