1. Go home and rest for the remainder of the day. Do no drive, operate appliances, or make any legal decisions today.

2. Have a responsible adult drive you home and remain with you for the rest of the day.

3. You may resume your normal diet after the procedure. Drink extra fluids (6 to 8 glasses per day) while the nephrostomy catheter is in place. Avoid alcoholic beverages and depressant drugs for 24 hours.

4. Do not take aspirin-containing products, ibuprofen, vitamin E, or blood-thinning products (*Coumadin) for 24 hours. You may take Tylenol (one to two tablets every four to six hours) for mild discomfort at the nephrostomy site. If you develop severe pain, swelling, or redness at the catheter insertion site, call Dr. Osterman's office at (305) 932-7800.

5. You will be sore for one to two weeks after the catheter is inserted. This may limit your activity. After that, you should continue to avoid any activity that causes a pulling sensation or pain around the catheter or kinking of the catheter. You may take a shower, but cover the dressing with plastic wrap so that it does not get wet. It may be easier to take a sponge bath. You may not take a tub bath.

a. Dressing change instruction
i. Avoid contact with shower water or bath water.
ii. Cover dressing and surrounding skin with a piece of plastic food wrap (cling wrap, siran wrap) then you may bathe or shower.
iii. Remove plastic wrap and dressing.
iv. Cleanse site with peroxide and sterile cotton ball, then allow to air dry.
v. Apply new sterile gauze dressing

6. A visiting nurse will help you learn how to care for the catheter site and dressing. We can assist you, or your primary care physician can assist you in making arrangements for the visiting nurse to come to your home.

7. Call Dr. Osterman at (305) 932-7800 immediately if you have pain in your side, if your catheter becomes dislodged or broken, if your catheter begins to leak large amounts of urine, if there is no drainage from the catheter that is open to a drainage bag, or if the skin around the catheter has discharge or starts to break down.

8. It is normal to have blood-tinged urine for two days after the procedure. If the bleeding persists, or there is a large amount of blood, call Dr. Osterman.

9. Report a temperature greater than 100ยบ Fahrenheit to us at (305) 932-7800.

10. Call Dr. Osterman's office for a follow-up appointment. Keep your appointments to have the nephrostomy catheter changed. In most cases the catheter is changed every 8 to 12 weeks. Changing the catheter helps prevent the catheter from becoming blocked. It is much easier to change a catheter than it is to place the original catheter. The catheter exchange can usually be done on an outpatient basis.

11. If you have any questions after you get home, please call Dr. Osterman's office at (305) 932-7800.

In most cases Coumadin therapy may be re-started 3 days after the procedure. You may discuss this with Dr. Osterman after the procedure or call the office for instructions.