Discharge Instructions for Nephrectomy (Child)

Your child had a nephrectomy. Their kidney was taken out because it wasn’t working properly. This condition was putting your child at risk for future problems, such as dangerous infections or high blood pressure. Now, your child can live a normal, healthy life with one kidney. Here’s what you’ll need to know about caring for your child after surgery.

Incision care

• Don’t let your child swim or sit in a bathtub or hot tub until the healthcare provider says it’s OK to do so. This helps prevent infection of the incision site.

• Let your child take showers as needed.

• Keep your child’s incision clean and dry. Wash the incision gently with mild soap and warm water. Then gently pat the incision dry with a clean towel.

• Don’t remove the white strips from your child’s incision. Let the strips fall off on their own.

Activity

• Don’t worry if your child feels more tired than usual. Fatigue and weakness are common for a few weeks after this surgery. Don't push your child to be active. Let your child rest as needed.

• Follow the healthcare provider's instructions regarding activity. Your child’s activity should be limited at first. It can then be gradually increased as they heal.

• Don’t let your child do strenuous activities, such as mowing the lawn or playing very active sports, contact sports, or games until the healthcare provider says it's OK.

• Tell your child to stop any activity that causes pain.

• Let your child go back to school as soon as they feel ready. Work with the school so that periods of rest can be provided if needed.

Other home care

• Unless the provider says otherwise, encourage your child to drink plenty of water. Give your child water or other fluids every 2 or 3 hours as directed by the provider.

• Feed your child a normal, healthy, well-balanced diet.

• Feed your child high-fiber foods to prevent constipation. Also, use laxatives, stool softeners, or enemas as directed by your child’s healthcare provider.

• Give your child pain medicine as directed. Don't change the pain medicine dose unless your child's healthcare provider says it is OK to do so.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical care

Call your child’s healthcare provider right away if your child has any of these:

• Fever (see Fever and children below), or as directed by the provider

• Shaking chills

• Nausea or vomiting

• Increased pain

• Blood in the urine

• Noticeable decrease in urine output

• Redness, swelling, warmth, or pain at the incision site

• Drainage, pus, or bleeding from the incision

• Incision that opens up or pulls apart

• New or worsening symptoms

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider