امرأة عمرها ٧٠ سنة عندها أنبوب كلوي عبر الجلد (Nephrostomy) بسبب ورم يسد الحالب. كان الأنبوب يصرف ٤٠ مل/ساعة، وفي آخر ٣ ساعات لم يخرج شيء، وتشتكي ألماً متزايداً في الخاصرة. الحرارة ٣٧٫٦. ما التصرف الصحيح؟

A 70-year-old woman has a nephrostomy tube for a tumour obstructing the ureter. It was draining 40 mL/h but nothing has drained for 3 hours, and she has increasing flank pain. T 37.6 °C. What is the correct action?

1. Flush it forcefully with a large volume of water using a syringe
2. Ignore it because the other kidney works well
3. Check for kinks and notify the provider; flush only if ordered
4. Pull the tube out slightly to free the blockage

Answer: C) Check for kinks and notify the provider; flush only if ordered. No drainage with pain usually means blockage or kinking. Check the tubing and notify the provider; irrigate only if ordered, gently and with a very small volume, as the renal pelvis is small.