Aim of the study: Investigate the effects of implementing nursing guidelines on acute Complications for patients with Percutaneous nephrostomy admitted to emergency unit. Setting: This study was carried out at Emergency unit at urology Hospital at Assuit University Hospital. Sample: A randomized controlled experimental study in which sixty patients were selected by convenience sampling of patients diagnosed with acute percutaneous nephrostomy complication, and assigned into two equal groups (30 patients each). Tools: four tools were used to collect the data in this study which are: Tool I: patient assessment sheet, Tool II: fluid electrolyte assessment sheet, Tool III: Tube Assessment and tool IV: patient outcomes. Results: There is a highly statistical difference between study and control groups concerning (Fluid & Electrolyte assessment (Intake and output)) with p-value (0.000) during all three days and there is very highly statistical difference between study and control groups regarding hospital stay with pvalue (0.000). Conclusion: application of the nursing guidelines impact positively on patients' outcomes of who have percutaneous nephrostomy complication. Recommendations: A hard copy of nursing guidelines should be distributed among patients underwent percutaneous nephrostomy tube.