PERCUTANEOUS NEPHROSTOMY TUBE PLACEMENT Flashcards

1
Q

refers to the placement of a small,
flexible catheter through your skin into
your kidney

A

Percutaneous Nephrostomy

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2
Q

Who introduced Percutaneous Nephrostomy and when was it introduced?

A

Dr. Willard Goodwin in 1955

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3
Q

what are the normal creatinine levels for adults?

A

0.6 to 1.5 mg/dL

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4
Q

Normal BUN levels

A

8 and 25 mg/100 mL

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5
Q

Indication for Percutaneous Nephrostomy

A

Drainage only
Stone treatment
Urine diversion
Other therapeutic intervention
Diagnosis of obstruction

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6
Q

contraindications for percutaneous nephrostomy

A
  • Bleeding diathesis
  • Uncooperative patient.
  • Uncontrolled hypertension.
  • Severe hyperkalemia
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7
Q

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

A

Bleeding diathesis

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8
Q

medical problem in which you have too much potassium in your blood

A

Hyperkalemia

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9
Q

What is the range of severe hyperkalemia

A

> 7 mEq/L

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10
Q

approaches to percutaneous nephrostomy

A
  1. eye of the needle approach
  2. one-stick or 2-stick technique
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11
Q

This uses the C-arm or fluoro placed so that the needle is parralel and pointed directly at the target calyx or stone.

A

eye of the needle approach

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12
Q

Typically, for PCNL, there is an existing, radio-opaque stone that can be used as a target
allowing the _______-

A

1-stick technique

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13
Q

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.

A

2-stick method

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14
Q

devices used in percutaneous nephrostomy

A
  • 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)
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15
Q

contrast media used in percutaneous nephrostomy

A

water-soluble contrast media

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16
Q

medications used in percutaneous nephrostomy

A
  • Prophylactic antibiotics
  • analgesia
  • sedation
17
Q

positioning in percutaneous nephrostomy

A

prone, prone oblique, or lateral
position,

18
Q

complications of percutaneous nephrostomy

A
  • Bleeding
  • Pneumothorax
  • Bowel Injury And Peritonitis
  • Urine Leak
  • Puncture of adjacent organs
  • Catheter Encrustation And Obstruction
  • Catheter Displacement - Reported At ~20% After A Few Months 6