Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

How can you effectively reduce fistula output?

1. Increase oral intake significantly

2. Limit oral/enteral intake while preventing mucosal atrophy

3. Administer high doses of pain medication

4. Encourage exercise to promote digestion

The correct answer is: Limit oral/enteral intake while preventing mucosal atrophy

To effectively reduce fistula output, limiting oral or enteral intake while preventing mucosal atrophy is an appropriate and evidence-based strategy. In patients with an enteric fistula, excessive output can lead to dehydration, electrolyte imbalances, and nutritional deficiencies. By thoughtfully managing oral or enteral intake, the volume of fluid and gastrointestinal secretions can be reduced, which may help in managing the output from the fistula. Furthermore, while restricting intake, it is critical to prevent mucosal atrophy. This can be accomplished through careful monitoring and providing appropriate nutritional support, such as enteral feeding that both meets the patient’s caloric needs and minimizes mucosal damage. Making sure that the intestines receive some degree of stimulation through limited intake helps maintain mucosal integrity without overwhelming the system. This approach focuses on achieving balance—reducing output to manage complications while ensuring the gut remains functional and healthy. Other strategies, such as increasing oral intake or exercise, might not address the underlying issue effectively, and administering pain medication can complicate the clinical picture without addressing the fistula output directly. Thus, the chosen strategy is most aligned with clinical practices aimed at managing fistula output effectively.