PERCUTANEOUS NEPHROSTOMY TUBE PLACEMENT Flashcards
refers to the placement of a small,
flexible catheter through your skin into
your kidney
Percutaneous Nephrostomy
Who introduced Percutaneous Nephrostomy and when was it introduced?
Dr. Willard Goodwin in 1955
what are the normal creatinine levels for adults?
0.6 to 1.5 mg/dL
Normal BUN levels
8 and 25 mg/100 mL
Indication for Percutaneous Nephrostomy
Drainage only
Stone treatment
Urine diversion
Other therapeutic intervention
Diagnosis of obstruction
contraindications for percutaneous nephrostomy
- Bleeding diathesis
- Uncooperative patient.
- Uncontrolled hypertension.
- Severe hyperkalemia
refers to an increased susceptibility to bleeding or bruising. Patients with Hemophilia is usually an inherited bleeding disorder in which the blood does not clot properly and are prone to bleeding diathesis
Bleeding diathesis
medical problem in which you have too much potassium in your blood
Hyperkalemia
What is the range of severe hyperkalemia
> 7 mEq/L
approaches to percutaneous nephrostomy
- eye of the needle approach
- one-stick or 2-stick technique
This uses the C-arm or fluoro placed so that the needle is parralel and pointed directly at the target calyx or stone.
eye of the needle approach
Typically, for PCNL, there is an existing, radio-opaque stone that can be used as a target
allowing the _______-
1-stick technique
In this method ____, the first needle puncture is used only to opacify the collecting system with contrast so that the final or definitive stick with another needle can be optimally directed.
2-stick method
devices used in percutaneous nephrostomy
- Ultrasound or fluoroscopy guidance
- Local anesthesia with 1% or 2% lidocaine
- 18 gauge puncture needle,
- 0.035 inch stiff guidewire
- Water-soluble contrast media
- Dilators ranging from 7-9 french
- Pigtail drain (typically 8 french)
contrast media used in percutaneous nephrostomy
water-soluble contrast media
