Nephrostomy

PREOP EVALUATION

  • Clinic Visit if outpatient
  • Needs to have recent Ultrasound, CT, or MRI (most will have recent ultrasound or CT)

TIMING / BED REST AFTER PROCEDURE

  • May need overnight observation, but most will be observed 3-4 hours then discharged same day

ANTICOAGULATION/ANTIPLATELETS

  • Aspirin or Plavix:  Do not stop
  • Lovenox, Low Molecular Weight Heparin (LMWH), Arixtra – Stop 24h prior to procedure
  • Pradaxa – stop 3 days prior to procedure if possible.  See “Warfarin” immediately below for “bridge” anticoagulation, if necessary (CONTACT IR physician if uncertain)
  • Warfarin (Coumadin) – Depends upon procedure and indication, as well as the reason the patient is taking this medication (CONTACT IR physician or PA)

LOCATION OF THE PROCEDURE
  • PREOPERATIVE ORDERS

    • Cath lab
    • IV with NS (Normal Saline) 75ml/hr

    FOLLOW UP

    • Call 1-2 days after procedure
    • Schedule for tube change in 3-4 months
    • If tube falls out, schedule for replacement in the next 24-48 hours (usually next day)

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